Provider Demographics
NPI:1033315460
Name:DIVELY, CHRISTINA L (DPT)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:L
Last Name:DIVELY
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
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Mailing Address - Street 1:310 PENN ST
Mailing Address - Street 2:SUITE 103
Mailing Address - City:HOLLIDAYSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:16648-2044
Mailing Address - Country:US
Mailing Address - Phone:814-695-2923
Mailing Address - Fax:814-695-2924
Practice Address - Street 1:7448 WOODBURY PIKE
Practice Address - Street 2:
Practice Address - City:ROARING SPRING
Practice Address - State:PA
Practice Address - Zip Code:16673-1600
Practice Address - Country:US
Practice Address - Phone:812-224-5566
Practice Address - Fax:814-224-2474
Is Sole Proprietor?:No
Enumeration Date:2007-06-22
Last Update Date:2013-10-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAPT018726225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist