Provider Demographics
NPI:1922338136
Name:CARR, CHRISTY (LICENSED MASSAGE THE)
Entity Type:Individual
Prefix:MS
First Name:CHRISTY
Middle Name:
Last Name:CARR
Suffix:
Gender:F
Credentials:LICENSED MASSAGE THE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5560 KELLY DR N
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33703
Mailing Address - Country:US
Mailing Address - Phone:727-692-8573
Mailing Address - Fax:
Practice Address - Street 1:5560 KELLY DR N
Practice Address - Street 2:
Practice Address - City:SAINT PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33703
Practice Address - Country:US
Practice Address - Phone:727-692-8573
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-11
Last Update Date:2011-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA0024911172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist