Provider Demographics
NPI:1740360668
Name:REBER, CHRISTINE MICHELLE (PT, FAAOMPT)
Entity type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:MICHELLE
Last Name:REBER
Suffix:
Gender:F
Credentials:PT, FAAOMPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 288
Mailing Address - Street 2:
Mailing Address - City:LIHUE
Mailing Address - State:HI
Mailing Address - Zip Code:96766
Mailing Address - Country:US
Mailing Address - Phone:808-632-0033
Mailing Address - Fax:808-632-0077
Practice Address - Street 1:3088 AUKELE STREET
Practice Address - Street 2:
Practice Address - City:LIHUE
Practice Address - State:HI
Practice Address - Zip Code:96766
Practice Address - Country:US
Practice Address - Phone:808-632-0033
Practice Address - Fax:808-632-0077
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2017-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT 193172251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAOPT193170Medicare ID - Type Unspecified