Provider Demographics
NPI:1992184469
Name:BRIGHTWELL, CHRISTINE ANN (DPT)
Entity Type:Individual
Prefix:MISS
First Name:CHRISTINE
Middle Name:ANN
Last Name:BRIGHTWELL
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4420 DIXIE HWY
Mailing Address - Street 2:SUITE 122
Mailing Address - City:SHIVELY
Mailing Address - State:KY
Mailing Address - Zip Code:40216-2988
Mailing Address - Country:US
Mailing Address - Phone:502-447-2750
Mailing Address - Fax:502-449-9062
Practice Address - Street 1:4420 DIXIE HWY
Practice Address - Street 2:SUITE 122
Practice Address - City:SHIVELY
Practice Address - State:KY
Practice Address - Zip Code:40216-2988
Practice Address - Country:US
Practice Address - Phone:502-447-2750
Practice Address - Fax:502-449-9062
Is Sole Proprietor?:No
Enumeration Date:2015-05-29
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY006607225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY006607OtherKENTUCKY PHYSICAL THERAPY LICENSE NUMBER