Provider Demographics
NPI:1275653313
Name:MUSGROVE, CHRISTINE (PT)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:MUSGROVE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:RR 1 BOX 46
Mailing Address - Street 2:
Mailing Address - City:GORIN
Mailing Address - State:MO
Mailing Address - Zip Code:63543-9712
Mailing Address - Country:US
Mailing Address - Phone:660-341-5412
Mailing Address - Fax:
Practice Address - Street 1:500 S JOHNSON ST
Practice Address - Street 2:SUITE 1
Practice Address - City:KAHOKA
Practice Address - State:MO
Practice Address - Zip Code:63445-1608
Practice Address - Country:US
Practice Address - Phone:660-727-3766
Practice Address - Fax:660-727-3799
Is Sole Proprietor?:No
Enumeration Date:2007-03-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO610225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist