Provider Demographics
NPI:1730195488
Name:CHRISTOFF, RYAN MARK (MSPT)
Entity type:Individual
Prefix:
First Name:RYAN
Middle Name:MARK
Last Name:CHRISTOFF
Suffix:
Gender:M
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:480 JOHNSON RD
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15301-8936
Mailing Address - Country:US
Mailing Address - Phone:724-223-2061
Mailing Address - Fax:724-223-2064
Practice Address - Street 1:480 JOHNSON RD
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:15301-8936
Practice Address - Country:US
Practice Address - Phone:724-223-2061
Practice Address - Fax:724-223-2064
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2014-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT01099L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
023485Medicare ID - Type Unspecified