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NPI 1255706909

NPI 1255706909 : CHRISTINA RENEA HITCHCOCK LMT : FALLON, NV

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General NPI Number Information
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    NPI Number           |    1255706909
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    Entity Type          |    Individual 
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    Provider Name        |    CHRISTINA RENEA HITCHCOCK LMT
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    12/07/2015
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    Last Update Date     |    12/07/2015
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Provider Practice Location Address
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    Address Line         |    67 WHITAKER LN 
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    City                 |    FALLON
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    State                |    NV
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    Zip                  |    89406-3142
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    Country              |    US
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    Telephone            |    775-217-0876
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    3091 CASEY RD 
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    City                 |    FALLON
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    State                |    NV
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    Zip                  |    89406-8893
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    Country              |    US
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    Telephone            |    775-217-0876
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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       |    NVMT.7590
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    License Number State |    NV
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