MEDICARE: CHRISTA KAYE ANTHONY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225200000X	Physical Therapy Assistant	5502000399	MI

General Provider Information

NPI Number	:	1043711682
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTA KAYE ANTHONY

Provider Business Mailing Address
First Line	:	251 WANONDOGER TRL
Second Line	:
City	:	BATTLE CREEK
State	:	MI
Zip	:	49017-8108
Country	:	US
Telephone Number	:	269-963-1242
Fax Number	:

Provider Business Practice Location Address
First Line	:	1150 MICHIGAN AVE E
Second Line	:
City	:	BATTLE CREEK
State	:	MI
Zip	:	49014-6113
Country	:	US
Telephone Number	:	269-275-1058
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/27/2018
Last Update Date	:	02/27/2018

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