Provider Demographics
NPI:1053649756
Name:PERKINS, CHRISTINE HOLLEY (RPT)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:HOLLEY
Last Name:PERKINS
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3671 APPLE BLOSSOM LANE
Mailing Address - Street 2:
Mailing Address - City:TURLOCK
Mailing Address - State:CA
Mailing Address - Zip Code:95382
Mailing Address - Country:US
Mailing Address - Phone:209-620-6301
Mailing Address - Fax:209-667-4787
Practice Address - Street 1:875 E CANAL DR
Practice Address - Street 2:5
Practice Address - City:TURLOCK
Practice Address - State:CA
Practice Address - Zip Code:95380-4550
Practice Address - Country:US
Practice Address - Phone:209-620-6301
Practice Address - Fax:209-667-4787
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-18
Last Update Date:2009-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT 17444225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist