Provider Demographics
NPI:1780787390
Name:GRIFFIN, CHRISTINA MICHELLE (PT)
Entity type:Individual
Prefix:MRS
First Name:CHRISTINA
Middle Name:MICHELLE
Last Name:GRIFFIN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:4007 CONSTITUTION
Mailing Address - Street 2:
Mailing Address - City:TEXARKANA
Mailing Address - State:TX
Mailing Address - Zip Code:75503
Mailing Address - Country:US
Mailing Address - Phone:903-832-2882
Mailing Address - Fax:903-793-1203
Practice Address - Street 1:1315 WALNUT
Practice Address - Street 2:TEMPLE MEMORIAL REHABILIATION CTR
Practice Address - City:TEXARKANA
Practice Address - State:TX
Practice Address - Zip Code:75501
Practice Address - Country:US
Practice Address - Phone:903-794-2705
Practice Address - Fax:903-793-1203
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPT2715225100000X, 2251P0200X
TX1148672225100000X, 2251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Not Answered2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR82695OtherAR BCBS
TX8T1689OtherBCBS TX