Provider Demographics
NPI:1851543318
Name:HUNT, CHRISTINE NICOLE (PTA)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:NICOLE
Last Name:HUNT
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:357 HARMONY CIR
Mailing Address - Street 2:
Mailing Address - City:ELM MOTT
Mailing Address - State:TX
Mailing Address - Zip Code:76640-3645
Mailing Address - Country:US
Mailing Address - Phone:254-822-1963
Mailing Address - Fax:254-822-0740
Practice Address - Street 1:3002 W 2ND AVE
Practice Address - Street 2:
Practice Address - City:CORSICANA
Practice Address - State:TX
Practice Address - Zip Code:75110-2408
Practice Address - Country:US
Practice Address - Phone:903-872-5130
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-15
Last Update Date:2008-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2038867225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant