Provider Demographics
NPI:1376869131
Name:SORTWELL, CHRISTINE HERRICK
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:HERRICK
Last Name:SORTWELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 ESTES ST
Mailing Address - Street 2:
Mailing Address - City:IPSWICH
Mailing Address - State:MA
Mailing Address - Zip Code:01938-2136
Mailing Address - Country:US
Mailing Address - Phone:978-500-6365
Mailing Address - Fax:
Practice Address - Street 1:1 N MAIN ST
Practice Address - Street 2:
Practice Address - City:IPSWICH
Practice Address - State:MA
Practice Address - Zip Code:01938-2217
Practice Address - Country:US
Practice Address - Phone:978-500-6365
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-19
Last Update Date:2010-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7885225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist