Provider Demographics
NPI:1487920435
Name:ENGLEHART, CHRIS J (LMT)
Entity type:Individual
Prefix:MR
First Name:CHRIS
Middle Name:J
Last Name:ENGLEHART
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:716 W MARKET ST
Mailing Address - Street 2:
Mailing Address - City:TIFFIN
Mailing Address - State:OH
Mailing Address - Zip Code:44883-2582
Mailing Address - Country:US
Mailing Address - Phone:419-443-8877
Mailing Address - Fax:
Practice Address - Street 1:716 W MARKET ST
Practice Address - Street 2:
Practice Address - City:TIFFIN
Practice Address - State:OH
Practice Address - Zip Code:44883-2582
Practice Address - Country:US
Practice Address - Phone:419-443-8877
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-23
Last Update Date:2012-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH011454174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist