MEDICARE: CHRISTINA PERRY

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	5501009319	MI

General Provider Information

NPI Number	:	1629571088
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINA PERRY

Provider Business Mailing Address
First Line	:	5141 SILVER COVE DR
Second Line	:
City	:	TRAVERSE CITY
State	:	MI
Zip	:	49685-8950
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5141 SILVER COVE DR
Second Line	:
City	:	TRAVERSE CITY
State	:	MI
Zip	:	49685-8950
Country	:	US
Telephone Number	:	231-649-6281
Fax Number	:

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

Provider Enumeration Date	:	03/13/2018
Last Update Date	:	03/13/2018

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Directions to “ CHRISTINA PERRY ” Practice Location

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