Basic Information
Provider Information
NPI: 1003139726
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KOTTER
FirstName: CHRIS
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: M.P.T.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
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OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 2860
Address2:  
City: ALAMOGORDO
State: NM
PostalCode: 883112860
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 2351 INDIAN WELLS
Address2:  
City: ALAMOGORDO
State: NM
PostalCode: 883105012
CountryCode: US
TelephoneNumber: 5754391397
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/09/2010
LastUpdateDate: 07/11/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X3836NMY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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