Provider Demographics
NPI:1801115449
Name:FREY, CHRISTIE TERESA (ATC, LAT)
Entity type:Individual
Prefix:
First Name:CHRISTIE
Middle Name:TERESA
Last Name:FREY
Suffix:
Gender:F
Credentials:ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 E JUDGE PEREZ DR
Mailing Address - Street 2:
Mailing Address - City:CHALMETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70043-5405
Mailing Address - Country:US
Mailing Address - Phone:504-301-2600
Mailing Address - Fax:504-301-2610
Practice Address - Street 1:1100 E JUDGE PEREZ DR
Practice Address - Street 2:
Practice Address - City:CHALMETTE
Practice Address - State:LA
Practice Address - Zip Code:70043-5405
Practice Address - Country:US
Practice Address - Phone:504-301-2600
Practice Address - Fax:504-301-2610
Is Sole Proprietor?:No
Enumeration Date:2010-05-21
Last Update Date:2010-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA2000282255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer