Provider Demographics
NPI:1184732075
Name:KING, CHRISTY MARIE (MPT)
Entity type:Individual
Prefix:MRS
First Name:CHRISTY
Middle Name:MARIE
Last Name:KING
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:CHRISTY
Other - Middle Name:MARIE
Other - Last Name:STEINBECKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MPT
Mailing Address - Street 1:1506 W. ST. JOESPH ST.
Mailing Address - Street 2:
Mailing Address - City:PERRYVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:63775
Mailing Address - Country:US
Mailing Address - Phone:573-517-7900
Mailing Address - Fax:573-517-7969
Practice Address - Street 1:1506 W SAINT JOSEPH ST
Practice Address - Street 2:
Practice Address - City:PERRYVILLE
Practice Address - State:MO
Practice Address - Zip Code:63775-1692
Practice Address - Country:US
Practice Address - Phone:573-517-7900
Practice Address - Fax:573-517-7969
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-29
Last Update Date:2024-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2004033967225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO220664766Medicare ID - Type Unspecified