Provider Demographics
NPI:1003611906
Name:SALOMON, CHRISTINE ANNE
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:ANNE
Last Name:SALOMON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:985 E MINGUS AVE APT 624
Mailing Address - Street 2:
Mailing Address - City:COTTONWOOD
Mailing Address - State:AZ
Mailing Address - Zip Code:86326-6715
Mailing Address - Country:US
Mailing Address - Phone:315-391-9181
Mailing Address - Fax:
Practice Address - Street 1:985 E MINGUS AVE APT 624
Practice Address - Street 2:
Practice Address - City:COTTONWOOD
Practice Address - State:AZ
Practice Address - Zip Code:86326-6715
Practice Address - Country:US
Practice Address - Phone:315-391-9181
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-14
Last Update Date:2025-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZMT-23029225700000X
NY08497-1225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist