Provider Demographics
NPI:1609040492
Name:MCMANIGAL, CHRISTINA MARIE (PT)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINA
Middle Name:MARIE
Last Name:MCMANIGAL
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MISS
Other - First Name:CHRISTINA
Other - Middle Name:MARIE
Other - Last Name:CASTELLANO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:551 LONE PINE BLVD
Mailing Address - Street 2:
Mailing Address - City:THE DALLES
Mailing Address - State:OR
Mailing Address - Zip Code:97058
Mailing Address - Country:US
Mailing Address - Phone:541-296-7202
Mailing Address - Fax:509-545-1112
Practice Address - Street 1:551 LONE PINE BLVD
Practice Address - Street 2:
Practice Address - City:THE DALLES
Practice Address - State:OR
Practice Address - Zip Code:97058
Practice Address - Country:US
Practice Address - Phone:541-296-7202
Practice Address - Fax:509-545-1112
Is Sole Proprietor?:No
Enumeration Date:2008-04-14
Last Update Date:2014-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV2189225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist