Provider Demographics
NPI:1225263668
Name:BOST, CHRISTINE LOUISE (PT, MS, DPT)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:LOUISE
Last Name:BOST
Suffix:
Gender:F
Credentials:PT, MS, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 MAXWELL CT
Mailing Address - Street 2:
Mailing Address - City:RICHMOND HILL
Mailing Address - State:GA
Mailing Address - Zip Code:31324-7719
Mailing Address - Country:US
Mailing Address - Phone:912-756-3090
Mailing Address - Fax:
Practice Address - Street 1:105 MAXWELL CT
Practice Address - Street 2:
Practice Address - City:RICHMOND HILL
Practice Address - State:GA
Practice Address - Zip Code:31324-7719
Practice Address - Country:US
Practice Address - Phone:904-982-4916
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-28
Last Update Date:2016-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT7463225100000X
GA74632251P0200X
FLPT22035225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics