Provider Demographics
NPI:1578878336
Name:CHRISTINE JEFFER DPM, LLC
Entity Type:Organization
Organization Name:CHRISTINE JEFFER DPM, LLC
Other - Org Name:PROACTIVE FOOT CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:JEFFER
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:513-677-5777
Mailing Address - Street 1:411 W LOVELAND AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:LOVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:45140-2357
Mailing Address - Country:US
Mailing Address - Phone:513-677-5777
Mailing Address - Fax:513-677-1444
Practice Address - Street 1:411 W LOVELAND AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:LOVELAND
Practice Address - State:OH
Practice Address - Zip Code:45140-2357
Practice Address - Country:US
Practice Address - Phone:513-677-5777
Practice Address - Fax:513-677-1444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-17
Last Update Date:2011-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36003319213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty