Provider Demographics
NPI:1093783342
Name:LINABURY, CHRISTINE ANNE (PT)
Entity Type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:ANNE
Last Name:LINABURY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2563 BEECHWOOD DR SE
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49506-4254
Mailing Address - Country:US
Mailing Address - Phone:616-942-2479
Mailing Address - Fax:
Practice Address - Street 1:1940 44TH ST SE
Practice Address - Street 2:
Practice Address - City:KENTWOOD
Practice Address - State:MI
Practice Address - Zip Code:49508-5008
Practice Address - Country:US
Practice Address - Phone:616-281-4556
Practice Address - Fax:616-281-4786
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501001815225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist