Provider Demographics
NPI:1609121649
Name:FLORA, CHRISTA MARIE (PT)
Entity Type:Individual
Prefix:MISS
First Name:CHRISTA
Middle Name:MARIE
Last Name:FLORA
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 1:792 W WOOD ST
Mailing Address - Street 2:
Mailing Address - City:LOWELLVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44436-1047
Mailing Address - Country:US
Mailing Address - Phone:330-501-9791
Mailing Address - Fax:
Practice Address - Street 1:885 HOWLAND-WILSON RD., NE
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44484-2100
Practice Address - Country:US
Practice Address - Phone:330-856-2107
Practice Address - Fax:330-856-2107
Is Sole Proprietor?:No
Enumeration Date:2012-07-16
Last Update Date:2012-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT.013734225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist