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General NPI Number Information
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NPI Number | 1184252819
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Entity Type | Individual
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Provider Name | CHRISTINA M. POOLE
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Gender | Female
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Dates
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Enumeration Date | 03/30/2020
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Last Update Date | 08/22/2022
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Provider Practice Location Address
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Address Line | 204 SHADY PINES CT
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City | FOUNTAIN INN
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State | SC
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Zip | 29644-9785
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Country | US
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Telephone | 644-089-5098
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Fax |
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Provider Business Mailing Address
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Address Line | 409 WINDWOOD ST
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City | SIMPSONVILLE
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State | SC
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Zip | 29680-6586
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Country | US
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Telephone | 864-680-3047
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 5537
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 5358
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License Number State | SC
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