Provider Demographics
NPI:1295997468
Name:BURPEE, CHRISTA JEAN (LMT)
Entity type:Individual
Prefix:
First Name:CHRISTA
Middle Name:JEAN
Last Name:BURPEE
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 GREAT FALLS PLZ
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:ME
Mailing Address - Zip Code:04210-5966
Mailing Address - Country:US
Mailing Address - Phone:207-782-3330
Mailing Address - Fax:207-782-7766
Practice Address - Street 1:2 GREAT FALLS PLZ
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:ME
Practice Address - Zip Code:04210-5966
Practice Address - Country:US
Practice Address - Phone:207-782-3330
Practice Address - Fax:207-782-7766
Is Sole Proprietor?:No
Enumeration Date:2008-06-30
Last Update Date:2008-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMT3109225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist