Provider Demographics
NPI:1104903384
Name:BORES, CHRISTOPHER JOSEPH (MPT)
Entity type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:JOSEPH
Last Name:BORES
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:291 S COLLIER BLVD
Mailing Address - Street 2:UNIT 105
Mailing Address - City:MARCO ISLAND
Mailing Address - State:FL
Mailing Address - Zip Code:34145-4829
Mailing Address - Country:US
Mailing Address - Phone:239-642-3948
Mailing Address - Fax:
Practice Address - Street 1:291 S COLLIER BLVD
Practice Address - Street 2:UNIT 105
Practice Address - City:MARCO ISLAND
Practice Address - State:FL
Practice Address - Zip Code:34145-4829
Practice Address - Country:US
Practice Address - Phone:239-642-3948
Practice Address - Fax:239-642-4243
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2017-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT21538225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist