Healthcare Provider Details
I. General information
NPI: 1033206370
Provider Name (Legal Business Name): CRISTINA RAYNE MADARANG MPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 10/06/2006
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
27 HUGH ST
BARNWELL SC
29812-3003
US
IV. Provider business mailing address
1200 CORPORATE DR STE 400
HOOVER AL
35242-5424
US
V. Phone/Fax
- Phone: 803-233-4536
- Fax:
- Phone: 423-238-7217
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | 9420 |
| License Number State | SC |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | LPT-033671 |
| License Number State | AZ |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: