Provider Demographics
NPI:1689859985
Name:SEBO, CHRISTA BETH (PT)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTA
Middle Name:BETH
Last Name:SEBO
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:CHRISTA
Other - Middle Name:BETH
Other - Last Name:LYNNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:1175 NININGER RD
Mailing Address - Street 2:
Mailing Address - City:HASTINGS
Mailing Address - State:MN
Mailing Address - Zip Code:55033
Mailing Address - Country:US
Mailing Address - Phone:651-480-4168
Mailing Address - Fax:651-480-4339
Practice Address - Street 1:85 PLEASANT DRIVE
Practice Address - Street 2:
Practice Address - City:HASTINGS
Practice Address - State:MN
Practice Address - Zip Code:55033
Practice Address - Country:US
Practice Address - Phone:651-480-4168
Practice Address - Fax:651-480-4339
Is Sole Proprietor?:No
Enumeration Date:2008-01-04
Last Update Date:2008-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN7778225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist