Provider Demographics
NPI:1255000154
Name:IKALINA, CHRISTIAN SUNDEE LERO (PT, DPT)
Entity Type:Individual
Prefix:
First Name:CHRISTIAN SUNDEE
Middle Name:LERO
Last Name:IKALINA
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 1:1200 CORPORATE DR STE 400
Mailing Address - Street 2:
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35242-5424
Mailing Address - Country:US
Mailing Address - Phone:866-518-0283
Mailing Address - Fax:
Practice Address - Street 1:2050 SCENIC HWY N STE A
Practice Address - Street 2:
Practice Address - City:SNELLVILLE
Practice Address - State:GA
Practice Address - Zip Code:30078-2688
Practice Address - Country:US
Practice Address - Phone:678-344-7197
Practice Address - Fax:678-344-7199
Is Sole Proprietor?:No
Enumeration Date:2021-09-13
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA02043200225100000X
GAPT016395225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist