Provider Demographics
NPI:1023390374
Name:FAIN, CHRISTINE NICOLE (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:NICOLE
Last Name:FAIN
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4794 SHILOH CANAAN RD
Mailing Address - Street 2:
Mailing Address - City:PALMYRA
Mailing Address - State:TN
Mailing Address - Zip Code:37142-2210
Mailing Address - Country:US
Mailing Address - Phone:931-320-6854
Mailing Address - Fax:
Practice Address - Street 1:4794 SHILOH CANAAN RD
Practice Address - Street 2:
Practice Address - City:PALMYRA
Practice Address - State:TN
Practice Address - Zip Code:37142-2210
Practice Address - Country:US
Practice Address - Phone:931-320-6854
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-13
Last Update Date:2019-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN12383208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation