MEDICARE: CHRISTINE HUSAR ATC, DPT

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	PT34915	FL

General Provider Information

NPI Number	:	1124674650
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINE HUSAR ATC, DPT

Provider Business Mailing Address
First Line	:	230 S DIXIE HWY
Second Line	:
City	:	HALLANDALE BEACH
State	:	FL
Zip	:	33009-5436
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	230 S DIXIE HWY
Second Line	:
City	:	HALLANDALE BEACH
State	:	FL
Zip	:	33009-5436
Country	:	US
Telephone Number	:	954-241-8036
Fax Number	:

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

Provider Enumeration Date	:	08/12/2019
Last Update Date	:	08/12/2019

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