Provider Demographics
NPI:1154801132
Name:PHILLIPS, CHRISTOPHER ANTHONY (MSPT, RPT, CSCS)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:ANTHONY
Last Name:PHILLIPS
Suffix:
Gender:M
Credentials:MSPT, RPT, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4902 OAKWOOD RD NW
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35806-1615
Mailing Address - Country:US
Mailing Address - Phone:256-508-6528
Mailing Address - Fax:
Practice Address - Street 1:4902 OAKWOOD RD NW
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35806-1615
Practice Address - Country:US
Practice Address - Phone:256-508-6528
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-18
Last Update Date:2020-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNPT0000007516225100000X
FLPT31843225100000X
ALPTH3158225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty