Provider Demographics
NPI:1043859754
Name:CROTTY, CHRISTINE TERESA (LMT)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:TERESA
Last Name:CROTTY
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:134 W BROAD ST FL 2
Mailing Address - Street 2:
Mailing Address - City:QUAKERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18951-1295
Mailing Address - Country:US
Mailing Address - Phone:215-534-1998
Mailing Address - Fax:
Practice Address - Street 1:519 W BROAD ST
Practice Address - Street 2:
Practice Address - City:QUAKERTOWN
Practice Address - State:PA
Practice Address - Zip Code:18951-1215
Practice Address - Country:US
Practice Address - Phone:267-509-7717
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-27
Last Update Date:2019-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMSG002434225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist