Provider Demographics
NPI:1265525794
Name:FOTI, CHRISTA MARIA (PHYSICAL THERAPIST)
Entity type:Individual
Prefix:
First Name:CHRISTA
Middle Name:MARIA
Last Name:FOTI
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 E RAPP RD
Mailing Address - Street 2:
Mailing Address - City:TALENT
Mailing Address - State:OR
Mailing Address - Zip Code:97540-8628
Mailing Address - Country:US
Mailing Address - Phone:541-951-6180
Mailing Address - Fax:541-535-1124
Practice Address - Street 1:810 E JACKSON ST
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97504-6773
Practice Address - Country:US
Practice Address - Phone:541-951-6180
Practice Address - Fax:541-535-1124
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2014-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR3199225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist