Healthcare Provider Details

I. General information

NPI: 1497253793
Provider Name (Legal Business Name): CHRISTI TRICHE RD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/01/2018
Last Update Date: 01/29/2026
Certification Date: 01/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 TWINING ST
MONTGOMERY AL
36112-6027
US

IV. Provider business mailing address

300 TWINING ST BLDG 760
MONTGOMERY AL
36112-6027
US

V. Phone/Fax

Practice location:
  • Phone: 334-953-5200
  • Fax:
Mailing address:
  • Phone: 334-953-5143
  • Fax: 334-953-8607

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number86092031
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: