Provider Demographics
NPI:1750366159
Name:RANEY, CHRISTY P (PT)
Entity type:Individual
Prefix:
First Name:CHRISTY
Middle Name:P
Last Name:RANEY
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:PO BOX 5002
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NC
Mailing Address - Zip Code:28111-5002
Mailing Address - Country:US
Mailing Address - Phone:704-289-4595
Mailing Address - Fax:704-541-6498
Practice Address - Street 1:701 E ROOSEVELT BLVD
Practice Address - Street 2:STE 200-A
Practice Address - City:MONROE
Practice Address - State:NC
Practice Address - Zip Code:28112-5170
Practice Address - Country:US
Practice Address - Phone:704-289-4595
Practice Address - Fax:704-220-1005
Is Sole Proprietor?:No
Enumeration Date:2005-12-08
Last Update Date:2013-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9061225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2506432Medicare ID - Type Unspecified