Provider Demographics
NPI:1497904130
Name:SLANE, CHRISTA (PT)
Entity Type:Individual
Prefix:
First Name:CHRISTA
Middle Name:
Last Name:SLANE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 CORPORATE DR
Mailing Address - Street 2:STE 400
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35242-5424
Mailing Address - Country:US
Mailing Address - Phone:423-238-8923
Mailing Address - Fax:423-954-7399
Practice Address - Street 1:29100 GATEWAY BLVD.
Practice Address - Street 2:SUITE 400
Practice Address - City:FLAT ROCK
Practice Address - State:MI
Practice Address - Zip Code:48134
Practice Address - Country:US
Practice Address - Phone:734-379-7900
Practice Address - Fax:734-379-9150
Is Sole Proprietor?:No
Enumeration Date:2008-09-18
Last Update Date:2022-04-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI5501006563225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI236836Medicare PIN