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General NPI Number Information
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NPI Number | 1831164367
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Entity Type | Individual
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Provider Name | CHRISTINE LEE LEVREAULT ATC
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Gender | Female
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Dates
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Enumeration Date | 02/20/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 20 COLLEGE RD
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City | RINDGE
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State | NH
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Zip | 03461-5046
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Country | US
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Telephone | 603-899-4366
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Fax |
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Provider Business Mailing Address
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Address Line | 36 DARWIN ST
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City | WOONSOCKET
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State | RI
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Zip | 02895-6314
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Country | US
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Telephone | 401-766-7730
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | AT00205
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License Number State | RI
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