Individual
CHRISTOPHER S PROCTOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
1139 3RD ST, SOUTH LAKE TAHOE, CA 96150-3465
(530) 541-3100
(530) 541-3016
Mailing address
PO BOX 529, ZEPHYR COVE, NV 89448-0529
(775) 588-8938
(775) 588-8930
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
1203
NV
225100000X
Physical Therapist
Primary
PT22738
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CC7486
BCBS
NV
01
—
P00211696
MEDICARE RAILROAD
CA
01
—
PT0227380
MEDI-CAL
CA
Enumeration date
11/03/2005
Last updated
11/16/2007
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