Healthcare Provider Details

I. General information

NPI: 1104243328
Provider Name (Legal Business Name): CHRISTI LEBLANC BERTI RRT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/26/2014
Last Update Date: 03/26/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

937 FLINTWOOD RD
FAYETTEVILLE NC
28314-5135
US

IV. Provider business mailing address

937 FLINTWOOD RD
FAYETTEVILLE NC
28314-5135
US

V. Phone/Fax

Practice location:
  • Phone: 910-818-7124
  • Fax:
Mailing address:
  • Phone: 910-818-7124
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227900000X
TaxonomyRegistered Respiratory Therapist
License Number3311
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: