Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225400000X | Rehabilitation Practitioner |
NPI | 1053769091 |
---|---|
Provider Name | Christopher Mckay |
First Address | Cedar Springs, MI 49319-9576 |
Second Address | Cedar Springs, MI 49319-9576 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/06/2016 |
Last Update Date | 01/06/2016 |