Provider Demographics
NPI:1770547242
Name:KUKOR, CHRISTINE RENEE (MOT, OTR/L, CLT)
Entity type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:RENEE
Last Name:KUKOR
Suffix:
Gender:F
Credentials:MOT, OTR/L, CLT
Other - Prefix:MS
Other - First Name:CHRISTINE
Other - Middle Name:RENEE
Other - Last Name:FRANCE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:54319 NATIONAL RD
Mailing Address - Street 2:
Mailing Address - City:BRIDGEPORT
Mailing Address - State:OH
Mailing Address - Zip Code:43912-9717
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4697 HARRISON ST
Practice Address - Street 2:
Practice Address - City:BELLAIRE
Practice Address - State:OH
Practice Address - Zip Code:43906-1338
Practice Address - Country:US
Practice Address - Phone:740-671-1436
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-13
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC009870225X00000X
OHOT.007657225X00000X
WV1367225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist