Provider Demographics
NPI:1912307521
Name:LABRIE, CHRISTINA (ATC)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:LABRIE
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 N GREENLEAF ST
Mailing Address - Street 2:
Mailing Address - City:GURNEE
Mailing Address - State:IL
Mailing Address - Zip Code:60031-3326
Mailing Address - Country:US
Mailing Address - Phone:847-623-3090
Mailing Address - Fax:847-623-9620
Practice Address - Street 1:105 N GREENLEAF ST
Practice Address - Street 2:
Practice Address - City:GURNEE
Practice Address - State:IL
Practice Address - Zip Code:60031-3326
Practice Address - Country:US
Practice Address - Phone:847-623-3090
Practice Address - Fax:847-623-9620
Is Sole Proprietor?:No
Enumeration Date:2014-09-02
Last Update Date:2014-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL096.0025352255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer