Provider Demographics
NPI:1104239250
Name:LINDE, CHRISTINE (ATC)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:LINDE
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:CHRIS
Other - Middle Name:
Other - Last Name:LINDE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:464 N 2150 W
Mailing Address - Street 2:
Mailing Address - City:PROVO
Mailing Address - State:UT
Mailing Address - Zip Code:84601-7243
Mailing Address - Country:US
Mailing Address - Phone:801-319-7732
Mailing Address - Fax:801-422-0038
Practice Address - Street 1:1136 SFH
Practice Address - Street 2:BRIGHAM YOUND UNIVERISTY
Practice Address - City:PROVO
Practice Address - State:UT
Practice Address - Zip Code:84602-2246
Practice Address - Country:US
Practice Address - Phone:801-422-7572
Practice Address - Fax:801-422-0038
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-06
Last Update Date:2014-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6332196-48102255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer