Provider Demographics
NPI:1679863336
Name:CHRISTOPHER, ANTHONY (OTR/L)
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:
Last Name:CHRISTOPHER
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:PO BOX 27107
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27611-7107
Mailing Address - Country:US
Mailing Address - Phone:516-205-8156
Mailing Address - Fax:
Practice Address - Street 1:100 CORNERSTONE DR
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27519-8453
Practice Address - Country:US
Practice Address - Phone:919-460-1921
Practice Address - Fax:919-460-1929
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-15
Last Update Date:2024-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC15020225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist