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General NPI Number Information
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NPI Number | 1831366137
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Entity Type | Organization
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Legal Business Name | CHRISTIE PHYSICAL THERAPY, PLLC
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Dates
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Enumeration Date | 05/15/2008
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Last Update Date | 01/26/2010
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Provider Practice Location Address
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Address Line | 8017 MESA DR #103
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City | AUSTIN
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State | TX
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Zip | 78731-1300
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Country | US
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Telephone | 512-791-3702
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Fax | 512-682-0220
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Provider Business Mailing Address
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Address Line | 8017 MESA DR #103
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City | AUSTIN
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State | TX
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Zip | 78731-1300
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Country | US
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Telephone | 512-791-3702
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Fax | 512-682-0220
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Authorized Official
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Title or Position | DIRECTOR PHYSICAL THERAPY
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Name | MR. COLEBURN ALAN CHRISTIE
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Credential | P.T.
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Telephone | 512-791-3702
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 1135614
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License Number State | TX
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