Provider Demographics
NPI:1255449690
Name:TAPSCOTT, CHRISTOPHER DEREK (PT)
Entity type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:DEREK
Last Name:TAPSCOTT
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 1:1579 CAPITAL AVE NE
Mailing Address - Street 2:
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49017-5381
Mailing Address - Country:US
Mailing Address - Phone:269-288-8410
Mailing Address - Fax:269-288-8414
Practice Address - Street 1:1579 CAPITAL AVE NE
Practice Address - Street 2:
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49017-5381
Practice Address - Country:US
Practice Address - Phone:269-288-8410
Practice Address - Fax:269-288-8414
Is Sole Proprietor?:No
Enumeration Date:2006-08-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501008913225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist