Provider Demographics
NPI:1285182204
Name:LEGG, CHRISTINA TALEV (DPT)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:TALEV
Last Name:LEGG
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4433 LATHROP DR
Mailing Address - Street 2:
Mailing Address - City:MARCELLUS
Mailing Address - State:NY
Mailing Address - Zip Code:13108-9737
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4279 CRESTED BUTTE RUN
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13215-1355
Practice Address - Country:US
Practice Address - Phone:315-569-9308
Practice Address - Fax:315-295-2579
Is Sole Proprietor?:No
Enumeration Date:2016-09-19
Last Update Date:2019-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist