Provider Demographics
NPI:1134248982
Name:GEORGE, CHRISTINA TERESE (PT)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:TERESE
Last Name:GEORGE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28080 CHARDON RD
Mailing Address - Street 2:STE 204
Mailing Address - City:WILLOUGHBY HILLS
Mailing Address - State:OH
Mailing Address - Zip Code:44092
Mailing Address - Country:US
Mailing Address - Phone:440-944-2863
Mailing Address - Fax:440-944-2697
Practice Address - Street 1:28080 CHARDON RD
Practice Address - Street 2:STE 204
Practice Address - City:WILLOUGHBY HILLS
Practice Address - State:OH
Practice Address - Zip Code:44092
Practice Address - Country:US
Practice Address - Phone:440-944-2863
Practice Address - Fax:440-944-2697
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT-07009225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist