Basic Information
| Provider Information | |||||||||
| NPI: | 1629245055 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SELLARS | ||||||||
| FirstName: | CHRISTOPHER | ||||||||
| MiddleName: | ROBERT | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1900 RIVERSIDE PKWY | ||||||||
| Address2: | |||||||||
| City: | LAWRENCEVILLE | ||||||||
| State: | GA | ||||||||
| PostalCode: | 300435925 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7702373475 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 4989 PEACHTREE PARKWAY | ||||||||
| Address2: | FIRST FLOOR | ||||||||
| City: | PEACHTREE CORNERS | ||||||||
| State: | GA | ||||||||
| PostalCode: | 300923009 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7707136480 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/14/2008 | ||||||||
| LastUpdateDate: | 06/12/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/12/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208100000X | 251654 | NY | N | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | 2081S0010X | 73392 | GA | Y | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | Sports Medicine |
No ID Information.