Provider Demographics
NPI:1376880880
Name:SMITH, CHRISTOPHER MATTHEW (ATC)
Entity type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:MATTHEW
Last Name:SMITH
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:261 BLUESTONE DR MSC 2301 GODWIN HL RM 128
Mailing Address - Street 2:JAMES MADISON UNIVERSITY
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22807-0001
Mailing Address - Country:US
Mailing Address - Phone:540-568-5847
Mailing Address - Fax:
Practice Address - Street 1:261 BLUESTONE DR MSC 2301 GODWIN HL RM 128
Practice Address - Street 2:261 BLUESTONE DR MSC 2301 GODWIN HALL ROOM 128
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22807-0001
Practice Address - Country:US
Practice Address - Phone:540-568-5847
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-04
Last Update Date:2013-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01260002432255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer