Provider Demographics
NPI:1376832147
Name:REAM, CHRISTA (LMT)
Entity Type:Individual
Prefix:
First Name:CHRISTA
Middle Name:
Last Name:REAM
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:830 E JOHNSTOWN RD
Mailing Address - Street 2:
Mailing Address - City:GAHANNA
Mailing Address - State:OH
Mailing Address - Zip Code:43230-3815
Mailing Address - Country:US
Mailing Address - Phone:614-209-7576
Mailing Address - Fax:
Practice Address - Street 1:830 E JOHNSTOWN RD
Practice Address - Street 2:
Practice Address - City:GAHANNA
Practice Address - State:OH
Practice Address - Zip Code:43230-3815
Practice Address - Country:US
Practice Address - Phone:614-209-7576
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-01
Last Update Date:2011-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH11629172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist