Healthcare Provider Details

I. General information

NPI: 1750648465
Provider Name (Legal Business Name): CHRISTINA LAH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/19/2012
Last Update Date: 04/19/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6347 VIA DE SONRISA DEL SUR
BOCA RATON FL
33433
US

IV. Provider business mailing address

3873 NW 2 CT
DEERFIELD BEACH FL
33442
US

V. Phone/Fax

Practice location:
  • Phone: 561-391-7700
  • Fax:
Mailing address:
  • Phone: 561-843-9473
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number8581
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: