Provider Demographics
NPI:1285112771
Name:HIGGINS, CHRISTOPHER (PT, DPT)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:
Last Name:HIGGINS
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 1:1005 N HICKORY RD
Mailing Address - Street 2:
Mailing Address - City:SOUTH BEND
Mailing Address - State:IN
Mailing Address - Zip Code:46615-2280
Mailing Address - Country:US
Mailing Address - Phone:574-233-5754
Mailing Address - Fax:
Practice Address - Street 1:108 N ADAMS ST
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:FL
Practice Address - Zip Code:32351-2404
Practice Address - Country:US
Practice Address - Phone:850-875-0333
Practice Address - Fax:850-875-0335
Is Sole Proprietor?:No
Enumeration Date:2018-08-06
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT40139225100000X
2251S0007X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports