Provider Demographics
NPI:1639314818
Name:HUNTER, CHRISTY JIVIDEN (LMT)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTY
Middle Name:JIVIDEN
Last Name:HUNTER
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 JERICHO RD
Mailing Address - Street 2:
Mailing Address - City:WINFIELD
Mailing Address - State:WV
Mailing Address - Zip Code:25213-9438
Mailing Address - Country:US
Mailing Address - Phone:304-586-4033
Mailing Address - Fax:
Practice Address - Street 1:115 JERICHO RD
Practice Address - Street 2:
Practice Address - City:WINFIELD
Practice Address - State:WV
Practice Address - Zip Code:25213-9438
Practice Address - Country:US
Practice Address - Phone:304-586-4033
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-02
Last Update Date:2008-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV1999-0421174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist