Provider Demographics
NPI:1821235961
Name:WERNLE, CHRISTINE ANNE (PT, DPT)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:ANNE
Last Name:WERNLE
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 1:139 FAIRBANKS RD
Mailing Address - Street 2:BUILDING 100-A
Mailing Address - City:CHURCHVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14428-9782
Mailing Address - Country:US
Mailing Address - Phone:585-293-1800
Mailing Address - Fax:
Practice Address - Street 1:139 FAIRBANKS RD
Practice Address - Street 2:BUILDING 100-A
Practice Address - City:CHURCHVILLE
Practice Address - State:NY
Practice Address - Zip Code:14428-9782
Practice Address - Country:US
Practice Address - Phone:585-293-1800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-12
Last Update Date:2012-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020065-12251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics