Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 7607 | AZ |
N | 2251S0007X | Physical Therapist - Sports | 7607 | AZ |
N | 2251X0800X | Physical Therapist - Orthopedic | 7607 | AZ |
NPI | 1114192531 |
---|---|
Provider Name | Mr. Christopher E Mccain |
First Address | Tucson, AZ 85751-1630 |
Second Address | Tucson, AZ 85741-3549 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/04/2008 |
Last Update Date | 16/04/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
341952 | (05) | AZ |