Provider Demographics
NPI:1497873426
Name:ZELTNER, CHRISTINE LOUISE (LMT)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:LOUISE
Last Name:ZELTNER
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 1:1130 MORNINGSTAR LN
Mailing Address - Street 2:
Mailing Address - City:FAIRMONT
Mailing Address - State:WV
Mailing Address - Zip Code:26554-1489
Mailing Address - Country:US
Mailing Address - Phone:304-363-6084
Mailing Address - Fax:
Practice Address - Street 1:2831 WHITE HALL BLVD
Practice Address - Street 2:
Practice Address - City:WHITE HALL
Practice Address - State:WV
Practice Address - Zip Code:26554
Practice Address - Country:US
Practice Address - Phone:304-368-9373
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV2001-0583225700000X
WVSLP-0406235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Not Answered235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist