Healthcare Provider Details

I. General information

NPI: 1033536024
Provider Name (Legal Business Name): CHRISTINA DENNEY MS, AT, LAT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2014
Last Update Date: 03/27/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3280 URBANA PIKE SUITE 202
IJAMSVILLE MD
21754-9406
US

IV. Provider business mailing address

3280 URBANA PIKE SUITE 202
IJAMSVILLE MD
21754-9406
US

V. Phone/Fax

Practice location:
  • Phone: 301-874-2226
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberA00137
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: