Provider Demographics
NPI:1982645834
Name:TEICHELMAN, CHRISTY DIANE (MPT)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTY
Middle Name:DIANE
Last Name:TEICHELMAN
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8810 W HWY 84
Mailing Address - Street 2:CROSSROADS WEST #404
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76612
Mailing Address - Country:US
Mailing Address - Phone:254-776-1739
Mailing Address - Fax:254-776-1578
Practice Address - Street 1:8810 W HWY 84
Practice Address - Street 2:CROSSROADS WEST #404
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76612
Practice Address - Country:US
Practice Address - Phone:254-776-1739
Practice Address - Fax:254-776-1578
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1141661225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist