MEDICARE: MS. CHRISTINE JO BIGHAM MPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	2305210864	VA
2	225100000X	Physical Therapist	21036	CA

General Provider Information

NPI Number	:	1043201122
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CHRISTINE JO BIGHAM MPT

Provider Business Mailing Address
First Line	:	3120 MCGEORGE TER
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22309-2128
Country	:	US
Telephone Number	:	573-855-0609
Fax Number	:

Provider Business Practice Location Address
First Line	:	9140 BELVOIR WOODS PKWY
Second Line	:
City	:	FORT BELVOIR
State	:	VA
Zip	:	22060-2703
Country	:	US
Telephone Number	:	703-799-1200
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/28/2005
Last Update Date	:	07/21/2022

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