Provider Demographics
NPI:1659587145
Name:LIBERT, CHRISTINA MARGARET (DPT)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:MARGARET
Last Name:LIBERT
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:836 WINTER HAVEN ST
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99504-1877
Mailing Address - Country:US
Mailing Address - Phone:907-646-9774
Mailing Address - Fax:907-646-9775
Practice Address - Street 1:2421 E. TUDOR ROAD STE 103
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99507
Practice Address - Country:US
Practice Address - Phone:907-646-9774
Practice Address - Fax:907-646-9775
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2012-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5467225100000X
AK1873225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist