Provider Demographics
NPI:1295251817
Name:MATHEW, CHRISTINA T (DPT)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:T
Last Name:MATHEW
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6914 HOLABIRD AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21222-1747
Mailing Address - Country:US
Mailing Address - Phone:410-284-5441
Mailing Address - Fax:410-284-5442
Practice Address - Street 1:1191 WOODSTOCK DR UNIT 2
Practice Address - Street 2:
Practice Address - City:ESTES PARK
Practice Address - State:CO
Practice Address - Zip Code:80517-5414
Practice Address - Country:US
Practice Address - Phone:970-236-2535
Practice Address - Fax:970-236-2568
Is Sole Proprietor?:No
Enumeration Date:2017-08-15
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO17651225100000X
MD26253225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist