Provider Demographics
NPI:1629390356
Name:PEREZ, CHRISTINA MICHELLE (ATC)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINA
Middle Name:MICHELLE
Last Name:PEREZ
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3799 ARABIAN CT
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43221-5600
Mailing Address - Country:US
Mailing Address - Phone:440-258-9757
Mailing Address - Fax:
Practice Address - Street 1:4605 SAWMILL ROAD
Practice Address - Street 2:
Practice Address - City:UPPER ARLINGTON
Practice Address - State:OH
Practice Address - Zip Code:43220-9300
Practice Address - Country:US
Practice Address - Phone:614-827-8253
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-22
Last Update Date:2015-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAT. 0030742255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer