Basic Information
| Provider Information | |||||||||
| NPI: | 1346480001 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DUGRE | ||||||||
| FirstName: | CHRISTOPHER | ||||||||
| MiddleName: | GEORGE | ||||||||
| NamePrefix: | MR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 65 COOPER ST | ||||||||
| Address2: | |||||||||
| City: | AGAWAM | ||||||||
| State: | MA | ||||||||
| PostalCode: | 010012149 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4137868000 | ||||||||
| FaxNumber: | 4133066401 | ||||||||
| Practice Location | |||||||||
| Address1: | 65 COOPER ST | ||||||||
| Address2: | |||||||||
| City: | AGAWAM | ||||||||
| State: | MA | ||||||||
| PostalCode: | 010012149 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4137868000 | ||||||||
| FaxNumber: | 4133066401 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/20/2009 | ||||||||
| LastUpdateDate: | 02/20/2009 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 18439 | MA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.