Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225X00000X | Occupational Therapist | ||
N | 225X00000X | Occupational Therapist | OT15663 | FL |
Y | 225XG0600X | Occupational Therapist - Gerontology |
NPI | 1205310125 |
---|---|
Provider Name | Christopher Bates |
First Address | Wesley Chapel, FL 33544-7770 |
Second Address | Dade City, FL 33525-4599 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/09/2018 |
Last Update Date | 17/09/2018 |