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Individual

MR. CHRIS G SHEPHERD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PTA

Contact information

Practice address
630 N FODALE AVE, SOUTHPORT, NC 28461-3538
(910) 457-0830
Mailing address
3563 ANTENNA FARM RD SE, BOLIVIA, NC 28422-7601
(440) 787-3087

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A2655
NC

Other

Enumeration date
01/29/2015
Last updated
01/29/2015
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