1760613376 NPI number — MR. CHRISTOPHER RYAN MASSEY MS, ATC, SCATC

Table of content: MR. CHRISTOPHER RYAN MASSEY MS, ATC, SCATC (NPI 1760613376)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1760613376 NPI number — MR. CHRISTOPHER RYAN MASSEY MS, ATC, SCATC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MASSEY
Provider First Name:
CHRISTOPHER
Provider Middle Name:
RYAN
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
MS, ATC, SCATC
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1760613376
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/30/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
11 PARIS CREEK CT
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GREENVILLE
Provider Business Mailing Address State Name:
SC
Provider Business Mailing Address Postal Code:
29617-7551
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
828-778-9345
Provider Business Mailing Address Fax Number:
864-294-3338

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
FURMAN UNIVERSITY
Provider Second Line Business Practice Location Address:
3300 POINSETT HWY
Provider Business Practice Location Address City Name:
GREENVILLE
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29613-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
864-294-2000
Provider Business Practice Location Address Fax Number:
864-294-3338
Provider Enumeration Date:
07/30/2009

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2255A2300X , with the licence number:  1080 , registered in the state of SC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 030702020 . This is a "NATABOC CERITIFICATION" identifier . This identifiers is of the category "OTHER".




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