Provider Demographics
NPI:1376688499
Name:ROOT, CHRISTINA (PT)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:ROOT
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 1:5968 MACEWEN CT
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43017-9417
Mailing Address - Country:US
Mailing Address - Phone:614-296-8378
Mailing Address - Fax:
Practice Address - Street 1:5968 MACEWEN CT
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43017-9417
Practice Address - Country:US
Practice Address - Phone:614-296-8378
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT.001383225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist