Provider Demographics
NPI:1194225847
Name:CALCATERRA, CHRISTINA MAE (MPT)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINA
Middle Name:MAE
Last Name:CALCATERRA
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:820 ARLINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:PETOSKEY
Mailing Address - State:MI
Mailing Address - Zip Code:49770-2469
Mailing Address - Country:US
Mailing Address - Phone:231-487-4200
Mailing Address - Fax:231-487-7791
Practice Address - Street 1:820 ARLINGTON AVE
Practice Address - Street 2:
Practice Address - City:PETOSKEY
Practice Address - State:MI
Practice Address - Zip Code:49770-2469
Practice Address - Country:US
Practice Address - Phone:231-487-4200
Practice Address - Fax:231-487-7791
Is Sole Proprietor?:No
Enumeration Date:2018-02-20
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501008983225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1992812580Medicaid