Provider Demographics
NPI:1063167401
Name:CABRAL, CHRISTOPHER M (PT, DPT)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:M
Last Name:CABRAL
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 PLAZA DR
Mailing Address - Street 2:
Mailing Address - City:SAINTE GENEVIEVE
Mailing Address - State:MO
Mailing Address - Zip Code:63670-1800
Mailing Address - Country:US
Mailing Address - Phone:573-608-5058
Mailing Address - Fax:844-912-8618
Practice Address - Street 1:2308 N TRUMAN BLVD
Practice Address - Street 2:
Practice Address - City:CRYSTAL CITY
Practice Address - State:MO
Practice Address - Zip Code:63019-1037
Practice Address - Country:US
Practice Address - Phone:636-206-6070
Practice Address - Fax:833-579-2992
Is Sole Proprietor?:No
Enumeration Date:2022-02-15
Last Update Date:2024-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2022004141225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist