Provider Demographics
NPI:1417079278
Name:IRWIN, CHRISTINE LYN (PT)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:LYN
Last Name:IRWIN
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 1:210 CLIFTON SPRINGS PROFESSIONAL PARK
Mailing Address - Street 2:
Mailing Address - City:CLIFTON SPRINGS
Mailing Address - State:NY
Mailing Address - Zip Code:14432-1041
Mailing Address - Country:US
Mailing Address - Phone:153-462-3588
Mailing Address - Fax:315-906-0058
Practice Address - Street 1:2211 LYELL AVE STE 102
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14606-5743
Practice Address - Country:US
Practice Address - Phone:585-426-3041
Practice Address - Fax:585-426-4031
Is Sole Proprietor?:No
Enumeration Date:2007-04-04
Last Update Date:2018-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC11024225100000X
NY043582225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist