MEDICARE: CHRISTINA HEMENWAY 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	2019003965	MO

General Provider Information

NPI Number	:	1578028072
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINA HEMENWAY DPT

Provider Business Mailing Address
First Line	:	8654 BIG BEND BLVD
Second Line	:
City	:	WEBSTER GROVES
State	:	MO
Zip	:	63119-3839
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8654 BIG BEND BLVD
Second Line	:
City	:	WEBSTER GROVES
State	:	MO
Zip	:	63119-3839
Country	:	US
Telephone Number	:	314-962-2634
Fax Number	:

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

Provider Enumeration Date	:	02/08/2019
Last Update Date	:	02/08/2019

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