Christopher Conley

Individual provider Active NPI Physical Therapy Assistant · Beaver, OH

NPI 1154714871 · NPPES record last updated Mar 5, 2015

Key facts

NPI
1154714871
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
2103190 (TX)
Practice address
1023 Buck Hollow Rd
Beaver, OH 45613-9704
Phone
(740) 941-8200
NPI assigned
Mar 5, 2015
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
11138AAZMDPhysical Therapy Assistant
5502004287MIMDPhysical Therapy Assistant
PTA 04602OHMDPhysical Therapy Assistant
2103190TXMDPhysical Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 2103190 TX Yes
Physical Therapy Assistant 225200000X PTA 04602 OH
Physical Therapy Assistant 225200000X 5502004287 MI
Physical Therapy Assistant 225200000X 11138A AZ

Addresses

Primary practice location

1023 Buck Hollow Rd
Beaver, OH 45613-9704

Mailing address

1023 Buck Hollow Rd
Beaver, OH 45613-9704
Phone (740) 941-8200

Other providers in Beaver, OH

All providers in Beaver, OH · Physical Therapy Assistant in Ohio

Sources for this page

Verify at the official NPI Registry.