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Individual

CHRISTIAN ROBERTS BEEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CP, BOCO

Contact information

Practice address
1103 N ELM ST STE 201, GREENSBORO, NC 27401
(336) 478-9400
(336) 478-9404
Mailing address
2534 EMPIRE DR, WINSTON SALEM, NC 27103-6710
(336) 397-2165
(336) 397-2167

Taxonomy

Speciality
Code
Description
License number
State
222Z00000X
Orthotist
C51530
224P00000X
Prosthetist
Primary
CP03333

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
C51530
THE BOARD OF CERTIFICATION / ACCREDITATION, INTERNATIONAL
01
CP03333
AMERICAN BOARD OF CERTIFICATION
01
PO000074
STATE LICENSE
PA
Enumeration date
05/30/2017
Last updated
08/01/2018
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