Provider Demographics
NPI:1164046272
Name:CHANSAMONE, CHRISTINE KESHIA
Entity Type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:KESHIA
Last Name:CHANSAMONE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01757-2613
Mailing Address - Country:US
Mailing Address - Phone:508-422-0101
Mailing Address - Fax:508-422-0102
Practice Address - Street 1:1027 BELLEVUE AVE STE 15
Practice Address - Street 2:
Practice Address - City:RICHMOND HEIGHTS
Practice Address - State:MO
Practice Address - Zip Code:63117-1851
Practice Address - Country:US
Practice Address - Phone:314-977-8724
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-04
Last Update Date:2021-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist