Provider Demographics
NPI:1356774178
Name:ROYALTY, CHRISTIANNA MARIE (PT)
Entity type:Individual
Prefix:
First Name:CHRISTIANNA
Middle Name:MARIE
Last Name:ROYALTY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:CHRISTIANNA
Other - Middle Name:MARIE
Other - Last Name:DOBSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:16 HYLAND RD
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615-5756
Mailing Address - Country:US
Mailing Address - Phone:864-627-1200
Mailing Address - Fax:864-627-7130
Practice Address - Street 1:16 HYLAND RD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29615-5756
Practice Address - Country:US
Practice Address - Phone:864-627-1200
Practice Address - Fax:864-627-7130
Is Sole Proprietor?:No
Enumeration Date:2013-08-15
Last Update Date:2024-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC7409225100000X
VA2305208095225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist