Christopher Manly Deck, COTA/L
Individual provider Active NPI Occupational Therapy Assistant · Bunnell, FL
NPI 1518225408 · NPPES record last updated Apr 27, 2012
Key facts
- NPI
- 1518225408
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapy Assistant 224Z00000X
- License
- OTA12002 (FL)
- Practice address
- 5795 Chestnut Ave
Bunnell, FL 32110 - Phone
- (386) 586-2840
- NPI assigned
- Apr 27, 2012
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| OTA12002 | FL | MD | Occupational Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | OTA12002 | FL | Yes |
Addresses
Primary practice location
5795 Chestnut Ave
Bunnell, FL 32110
Mailing address
5795 Chestnut Ave
Bunnell, FL 32110
Other providers in Bunnell, FL
- Erin Stewart Crimmins
- Robert Aloysius Crimmins
- Nancy Hutt Culver
- Klara Dandrea
- Bethany Ann Danner
- Delta Health Group Inc
- Dewey World Recovery Community Inc
- Francine T Dias
- Discount Medical Supply, Inc
- Mary Dreggors
All providers in Bunnell, FL · Occupational Therapy Assistant in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 27, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.