Provider Demographics
NPI:1992263461
Name:MELCHER, CHRISTOPHER K (PT)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:K
Last Name:MELCHER
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3011 S LINDSAY RD STE 114
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85295-4334
Mailing Address - Country:US
Mailing Address - Phone:480-814-8222
Mailing Address - Fax:
Practice Address - Street 1:3011 S LINDSAY RD STE 114
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85295-4334
Practice Address - Country:US
Practice Address - Phone:480-814-8222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-04
Last Update Date:2019-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ30361225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist