Provider Demographics
NPI:1013371178
Name:SPANGLER, CHRISTINA EAN (LMT, CMTPT)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:EAN
Last Name:SPANGLER
Suffix:
Gender:F
Credentials:LMT, CMTPT
Other - Prefix:
Other - First Name:EAN
Other - Middle Name:
Other - Last Name:SPANGLER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMT, CMTPT
Mailing Address - Street 1:47 MOUNT VERNON ST
Mailing Address - Street 2:APT 2
Mailing Address - City:WEST ROXBURY
Mailing Address - State:MA
Mailing Address - Zip Code:02132-2824
Mailing Address - Country:US
Mailing Address - Phone:860-977-2766
Mailing Address - Fax:
Practice Address - Street 1:30 GERMANIA ST
Practice Address - Street 2:BUILDING L, THIRD FLOOR
Practice Address - City:JAMAICA PLAIN
Practice Address - State:MA
Practice Address - Zip Code:02130-2315
Practice Address - Country:US
Practice Address - Phone:860-977-2766
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-05
Last Update Date:2016-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA9371225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist