Provider Demographics
NPI:1528399870
Name:SARGENT, CHRISTINE BROWN (PT)
Entity Type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:BROWN
Last Name:SARGENT
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 1:2105 GILA RIVER RD NE
Mailing Address - Street 2:
Mailing Address - City:RIO RANCHO
Mailing Address - State:NM
Mailing Address - Zip Code:87144-5705
Mailing Address - Country:US
Mailing Address - Phone:505-867-4316
Mailing Address - Fax:
Practice Address - Street 1:2105 GILA RIVER RD NE
Practice Address - Street 2:
Practice Address - City:RIO RANCHO
Practice Address - State:NM
Practice Address - Zip Code:87144-5705
Practice Address - Country:US
Practice Address - Phone:505-867-4316
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-27
Last Update Date:2010-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM2177225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist