Provider Demographics
NPI:1114568565
Name:MONSEN, TODD CHRISTINA (PT, DPT)
Entity Type:Individual
Prefix:
First Name:TODD
Middle Name:CHRISTINA
Last Name:MONSEN
Suffix:
Gender:M
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 1:611 W STATE HIGHWAY 6 STE 109
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76710-7545
Mailing Address - Country:US
Mailing Address - Phone:254-300-1941
Mailing Address - Fax:
Practice Address - Street 1:611 W STATE HIGHWAY 6 STE 109
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76710-7545
Practice Address - Country:US
Practice Address - Phone:254-300-1941
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-07
Last Update Date:2019-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1278265225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist