MEDICARE: MS. CHRISTINE ANNE LINABURY PT

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	5501001815	MI

General Provider Information

NPI Number	:	1093783342
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CHRISTINE ANNE LINABURY PT

Provider Business Mailing Address
First Line	:	2563 BEECHWOOD DR SE
Second Line	:
City	:	GRAND RAPIDS
State	:	MI
Zip	:	49506-4254
Country	:	US
Telephone Number	:	616-942-2479
Fax Number	:

Provider Business Practice Location Address
First Line	:	1940 44TH ST SE
Second Line	:
City	:	KENTWOOD
State	:	MI
Zip	:	49508-5008
Country	:	US
Telephone Number	:	616-281-4556
Fax Number	:	616-281-4786

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

Provider Enumeration Date	:	03/11/2006
Last Update Date	:	07/08/2007

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