Healthcare Provider Details

I. General information

NPI: 1336768019
Provider Name (Legal Business Name): CHRISTA CELINE KARR PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2020
Last Update Date: 04/13/2020
Certification Date: 04/13/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2999 NEW CENTER PT
COLORADO SPRINGS CO
80922-2806
US

IV. Provider business mailing address

4780 W OLD FARM CIR
COLORADO SPRINGS CO
80917-1028
US

V. Phone/Fax

Practice location:
  • Phone: 719-365-5842
  • Fax: 719-365-6878
Mailing address:
  • Phone: 719-432-7218
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number0012274
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: