Provider Demographics
NPI:1629003520
Name:MAYER, CHRISTIE LEIGH (PT)
Entity Type:Individual
Prefix:
First Name:CHRISTIE
Middle Name:LEIGH
Last Name:MAYER
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 1:311 E INDIANTOWN RD
Mailing Address - Street 2:SUITE C-4
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33477-5062
Mailing Address - Country:US
Mailing Address - Phone:561-575-4770
Mailing Address - Fax:561-575-4522
Practice Address - Street 1:311 E INDIANTOWN RD
Practice Address - Street 2:SUITE C-4
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33477-5062
Practice Address - Country:US
Practice Address - Phone:561-575-4770
Practice Address - Fax:561-575-4522
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT18487225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist