Provider Demographics
NPI:1235221425
Name:KULLMER, CHRISTINA LYNN (MPT)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINA
Middle Name:LYNN
Last Name:KULLMER
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 1:709 W MAIN ST
Mailing Address - Street 2:PO BOX 359
Mailing Address - City:MANCHESTER
Mailing Address - State:IA
Mailing Address - Zip Code:52057-1526
Mailing Address - Country:US
Mailing Address - Phone:563-927-7322
Mailing Address - Fax:563-927-7518
Practice Address - Street 1:709 W MAIN ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:IA
Practice Address - Zip Code:52057-1526
Practice Address - Country:US
Practice Address - Phone:563-927-7322
Practice Address - Fax:563-927-7518
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2016-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPT1149580225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX116296OtherCHIPS
TXA005OtherTRICARE
TX8T1216OtherBLUE CROSS BLUE SHIELD
TX177978600OtherACS DEPT OF LABOR
TX056736OtherVALLEY HEALTH PLANS
TX160360701Medicaid
TXP00047981OtherMEDICARE RAILROAD
TX160360701Medicaid