Basic Information
| Provider Information | |||||||||
| NPI: | 1356525844 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DOCKERY | ||||||||
| FirstName: | CHRIS | ||||||||
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| Credential: | PTA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 110 SMITH RD | ||||||||
| Address2: | |||||||||
| City: | PARRISH | ||||||||
| State: | AL | ||||||||
| PostalCode: | 355805326 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2053886350 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3101 10TH ST | ||||||||
| Address2: | |||||||||
| City: | WICHITA FALLS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 763092103 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9407660281 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/20/2007 | ||||||||
| LastUpdateDate: | 12/20/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225200000X | AL | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapy Assistant |
No ID Information.