MEDICARE: CHRISTOPHER GERHARDT DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	5501017638	MI

General Provider Information

NPI Number	:	1811357700
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTOPHER GERHARDT DPT

Provider Business Mailing Address
First Line	:	1773 STAR BATT DR
Second Line	:
City	:	ROCHESTER HILLS
State	:	MI
Zip	:	48309-3708
Country	:	US
Telephone Number	:	248-650-4720
Fax Number	:	248-650-8670

Provider Business Practice Location Address
First Line	:	21550 HARRINGTON ST
Second Line	:	STE D.
City	:	CLINTON TWP
State	:	MI
Zip	:	48036-2362
Country	:	US
Telephone Number	:	586-783-7590
Fax Number	:	586-783-7876

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/04/2016
Last Update Date	:	03/04/2016

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