Provider Demographics
NPI:1437609815
Name:FALES, CHRISTINA LR (LMT)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:LR
Last Name:FALES
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 1:563 CENTER ST
Mailing Address - Street 2:2C
Mailing Address - City:LUDLOW
Mailing Address - State:MA
Mailing Address - Zip Code:01056-2899
Mailing Address - Country:US
Mailing Address - Phone:413-547-1238
Mailing Address - Fax:
Practice Address - Street 1:563 CENTER ST
Practice Address - Street 2:2C
Practice Address - City:LUDLOW
Practice Address - State:MA
Practice Address - Zip Code:01056-2899
Practice Address - Country:US
Practice Address - Phone:413-547-1238
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-10
Last Update Date:2016-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA8441172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist