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General NPI Number Information
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NPI Number | 1154895910
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Entity Type | Individual
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Provider Name | CHRISTIANA MARIE SPENCER ATS
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Gender | Female
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Dates
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Enumeration Date | 01/15/2019
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Last Update Date | 10/16/2025
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Provider Practice Location Address
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Address Line | 1279 W FRONTAGE RD UNIT H
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City | RIO RICO
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State | AZ
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Zip | 85648-6258
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Country | US
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Telephone | 520-375-2127
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Fax |
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Provider Business Mailing Address
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Address Line | 790 REMINGTON BLVD
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City | BOLINGBROOK
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State | IL
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Zip | 60440-4909
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Country | US
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Telephone |
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 070028020
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 30622
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 13351
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License Number State | MN
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Taxonomy #4
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 41502
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License Number State | FL
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Taxonomy #5
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PTL27708
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License Number State | MA
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