Provider Demographics
NPI:1649451808
Name:WHITE, CHRISTINA J (CMT)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:J
Last Name:WHITE
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6910 N MAIN ST
Mailing Address - Street 2:UNIT 23
Mailing Address - City:GRANGER
Mailing Address - State:IN
Mailing Address - Zip Code:46530-9680
Mailing Address - Country:US
Mailing Address - Phone:574-361-2964
Mailing Address - Fax:
Practice Address - Street 1:6910 N MAIN ST
Practice Address - Street 2:UNIT 23
Practice Address - City:GRANGER
Practice Address - State:IN
Practice Address - Zip Code:46530-9680
Practice Address - Country:US
Practice Address - Phone:574-361-2964
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-16
Last Update Date:2007-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist