Provider Demographics
NPI:1063698090
Name:ANTHONY, CHRISTINE B (PHYSICAL THERAPIST)
Entity type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:B
Last Name:ANTHONY
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
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Mailing Address - Street 1:435 HARTFORD TPKE
Mailing Address - Street 2:SUITE U
Mailing Address - City:VERNON
Mailing Address - State:CT
Mailing Address - Zip Code:06066-4852
Mailing Address - Country:US
Mailing Address - Phone:860-979-1600
Mailing Address - Fax:203-866-3014
Practice Address - Street 1:58A WEST STAFFORD ROAD
Practice Address - Street 2:
Practice Address - City:STAFFORD SPRINGS
Practice Address - State:CT
Practice Address - Zip Code:06076
Practice Address - Country:US
Practice Address - Phone:860-684-6895
Practice Address - Fax:860-684-5263
Is Sole Proprietor?:No
Enumeration Date:2008-01-22
Last Update Date:2015-01-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CT0005111225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT650000384Medicare PIN