Provider Demographics
NPI:1518413236
Name:STUART, CHRISTINE (PT)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:STUART
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 BIRCH BOTTOM CIRCLE
Mailing Address - Street 2:
Mailing Address - City:ROCKLAND
Mailing Address - State:MA
Mailing Address - Zip Code:02370
Mailing Address - Country:US
Mailing Address - Phone:617-871-3242
Mailing Address - Fax:
Practice Address - Street 1:29 BIRCH BOTTOM CIRCLE
Practice Address - Street 2:
Practice Address - City:ROCKLAND
Practice Address - State:MA
Practice Address - Zip Code:02370
Practice Address - Country:US
Practice Address - Phone:781-871-3242
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-01
Last Update Date:2016-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA8256225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist