Provider Demographics
NPI:1538612130
Name:WALTERS, CHRISTOPHER MICHAEL (OTR/L)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:MICHAEL
Last Name:WALTERS
Suffix:
Gender:M
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2499 ZERBE RD
Mailing Address - Street 2:ATTN: THERAPY DEPT
Mailing Address - City:NARVON
Mailing Address - State:PA
Mailing Address - Zip Code:17555-9328
Mailing Address - Country:US
Mailing Address - Phone:717-445-4551
Mailing Address - Fax:
Practice Address - Street 1:2499 ZERBE RD
Practice Address - Street 2:ATTN: THERAPY DEPT
Practice Address - City:NARVON
Practice Address - State:PA
Practice Address - Zip Code:17555-9328
Practice Address - Country:US
Practice Address - Phone:717-445-4551
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-31
Last Update Date:2016-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC014201225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist