Provider Demographics
NPI:1518013176
Name:CONROY, CHRISTY L (MSPT)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTY
Middle Name:L
Last Name:CONROY
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2036 TRAILING PINES WAY
Mailing Address - Street 2:
Mailing Address - City:ORANGE PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32003-4921
Mailing Address - Country:US
Mailing Address - Phone:904-541-1620
Mailing Address - Fax:
Practice Address - Street 1:550 WELLS RD STE 4
Practice Address - Street 2:
Practice Address - City:ORANGE PARK
Practice Address - State:FL
Practice Address - Zip Code:32073-2950
Practice Address - Country:US
Practice Address - Phone:904-278-7890
Practice Address - Fax:904-278-7762
Is Sole Proprietor?:No
Enumeration Date:2007-01-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT20435225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist