Provider Demographics
NPI:1336106061
Name:GODFREY, CHRISTINA FRANCIS (PTA)
Entity Type:Individual
Prefix:MISS
First Name:CHRISTINA
Middle Name:FRANCIS
Last Name:GODFREY
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2070 COCKRELLS RUN ROAD
Mailing Address - Street 2:
Mailing Address - City:LUCASVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45648
Mailing Address - Country:US
Mailing Address - Phone:740-259-5883
Mailing Address - Fax:
Practice Address - Street 1:8046 OHIO RIVER ROAD
Practice Address - Street 2:SUITE D
Practice Address - City:WHEELERSBURG
Practice Address - State:OH
Practice Address - Zip Code:45694
Practice Address - Country:US
Practice Address - Phone:740-574-4433
Practice Address - Fax:740-574-4765
Is Sole Proprietor?:No
Enumeration Date:2006-04-27
Last Update Date:2007-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5275225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant