Provider Demographics
NPI:1598093411
Name:KOOSER, CHRISTINE L (NCMT, LMT)
Entity Type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:L
Last Name:KOOSER
Suffix:
Gender:F
Credentials:NCMT, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8888 LADUE RD
Mailing Address - Street 2:SUITE 260
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63124-2056
Mailing Address - Country:US
Mailing Address - Phone:314-721-7683
Mailing Address - Fax:314-721-7683
Practice Address - Street 1:8888 LADUE RD
Practice Address - Street 2:SUITE 260
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63124-2056
Practice Address - Country:US
Practice Address - Phone:314-721-7683
Practice Address - Fax:314-721-7683
Is Sole Proprietor?:No
Enumeration Date:2009-12-04
Last Update Date:2009-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist