Provider Demographics
NPI:1952883795
Name:HORNE, CHRISTINA MICHELLE (LMT, CFL1, CFK)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINA
Middle Name:MICHELLE
Last Name:HORNE
Suffix:
Gender:F
Credentials:LMT, CFL1, CFK
Other - Prefix:MISS
Other - First Name:CHRISTINA
Other - Middle Name:MICHELLE
Other - Last Name:KELLY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5404 VERMILLION BLUFFS DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80923-3401
Mailing Address - Country:US
Mailing Address - Phone:772-532-7999
Mailing Address - Fax:
Practice Address - Street 1:6160 TUTT BLVD STE 102
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80923-3503
Practice Address - Country:US
Practice Address - Phone:719-215-8722
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-29
Last Update Date:2018-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COMT0021598225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist