Provider Demographics
NPI:1639497936
Name:THE, CHRISTI MARIE (PT, DPT)
Entity Type:Individual
Prefix:
First Name:CHRISTI
Middle Name:MARIE
Last Name:THE
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10700 MEDLOCK BRIDGE RD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30097-8456
Mailing Address - Country:US
Mailing Address - Phone:770-623-0105
Mailing Address - Fax:770-623-0602
Practice Address - Street 1:10700 MEDLOCK BRIDGE RD
Practice Address - Street 2:SUITE 105
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30097-8456
Practice Address - Country:US
Practice Address - Phone:770-623-0105
Practice Address - Fax:770-623-0602
Is Sole Proprietor?:No
Enumeration Date:2010-05-11
Last Update Date:2012-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT010205225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist