Provider Demographics
NPI:1336114883
Name:RANS, CRISTIE (ATC)
Entity Type:Individual
Prefix:
First Name:CRISTIE
Middle Name:
Last Name:RANS
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 1:1722 E COUNTY ROAD 650 N
Mailing Address - Street 2:
Mailing Address - City:LUCERNE
Mailing Address - State:IN
Mailing Address - Zip Code:46950-9315
Mailing Address - Country:US
Mailing Address - Phone:574-889-2103
Mailing Address - Fax:
Practice Address - Street 1:1722 E COUNTY ROAD 650 N
Practice Address - Street 2:
Practice Address - City:LUCERNE
Practice Address - State:IN
Practice Address - Zip Code:46950-9315
Practice Address - Country:US
Practice Address - Phone:574-889-2103
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN36000092A2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer