Provider Demographics
NPI:1235406364
Name:MICHIE, CHRISTOPHER A (OTR/L)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:A
Last Name:MICHIE
Suffix:
Gender:M
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 EASTPARK CRES
Mailing Address - Street 2:
Mailing Address - City:CELEBRATION
Mailing Address - State:FL
Mailing Address - Zip Code:34747-5030
Mailing Address - Country:US
Mailing Address - Phone:321-939-0536
Mailing Address - Fax:321-939-0536
Practice Address - Street 1:105 EASTPARK CRES
Practice Address - Street 2:
Practice Address - City:CELEBRATION
Practice Address - State:FL
Practice Address - Zip Code:34747-5030
Practice Address - Country:US
Practice Address - Phone:321-939-0536
Practice Address - Fax:321-939-0536
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-17
Last Update Date:2020-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL6754225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist