Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | PT011560 | GA |
NPI | 1003224171 |
---|---|
Provider Name | Christopher L Hendley |
First Address | Peachtree City, GA 30269-3081 |
Second Address | Peachtree City, GA 30269-3081 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/08/2014 |
Last Update Date | 01/08/2014 |