Provider Demographics
NPI:1568691368
Name:RIDDER, CHRISTINE M (PT)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:M
Last Name:RIDDER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:CHRISTINE
Other - Middle Name:M
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:2810 W 35TH ST
Mailing Address - Street 2:STE 2
Mailing Address - City:KEARNEY
Mailing Address - State:NE
Mailing Address - Zip Code:68845-2909
Mailing Address - Country:US
Mailing Address - Phone:308-237-7388
Mailing Address - Fax:308-237-7394
Practice Address - Street 1:516 W 14TH AVE
Practice Address - Street 2:STE 200
Practice Address - City:HOLDREGE
Practice Address - State:NE
Practice Address - Zip Code:68949
Practice Address - Country:US
Practice Address - Phone:308-995-2865
Practice Address - Fax:308-995-4127
Is Sole Proprietor?:No
Enumeration Date:2009-07-14
Last Update Date:2014-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2793225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist