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Individual

CHRISTOPHER S BETHARD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1288 S GOVERNORS AVE, DOVER, DE 19904-4802
(302) 677-0100
(302) 677-0267
Mailing address
1812 MARSH RD, STORE 505, WILMINGTON, DE 19810-4581
(302) 793-1800
(302) 793-0800

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
J1-0000933
DE
2251S0007X
Sports Physical Therapist
J3-0000066
DE
2251X0800X
Orthopedic Physical Therapist
JI-0000933
DE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0751198000
IBC
01
11220683
CAQH
01
1366573933
CHAMPUS
05
1366593933
DE
01
5070-0071
CAREFIRST
01
88760518
NCA
Enumeration date
03/08/2007
Last updated
03/09/2009
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