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General NPI Number Information
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NPI Number | 1073954830
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Entity Type | Individual
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Provider Name | CHRISTINE GAVE LPTA
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Gender | Female
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Dates
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Enumeration Date | 07/09/2013
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Last Update Date | 07/09/2013
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Provider Practice Location Address
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Address Line | 38777 6 MILE RD
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City | LIVONIA
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State | MI
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Zip | 48152-2694
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Country | US
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Telephone | 888-414-7056
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Fax |
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Provider Business Mailing Address
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Address Line | 46062 OAKLAWN ST
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City | MACOMB
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State | MI
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Zip | 48042-5337
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Country | US
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Telephone | 586-567-1982
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 5502001238
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License Number State | MI
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