Provider Demographics
NPI:1184124166
Name:ROECKL-NAVAZIO, CHRISTINA (ATC)
Entity type:Individual
Prefix:MS
First Name:CHRISTINA
Middle Name:
Last Name:ROECKL-NAVAZIO
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2023 HARRY LORENZO AVE
Mailing Address - Street 2:
Mailing Address - City:WOODLAND
Mailing Address - State:CA
Mailing Address - Zip Code:95776-5482
Mailing Address - Country:US
Mailing Address - Phone:530-902-0259
Mailing Address - Fax:
Practice Address - Street 1:510 S MULLER PKWY
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:IN
Practice Address - Zip Code:47403-1616
Practice Address - Country:US
Practice Address - Phone:530-902-0259
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-16
Last Update Date:2021-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer