Provider Demographics
NPI:1104543958
Name:BELTRAN, CHRISTINE ANN
Entity type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:ANN
Last Name:BELTRAN
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:CHRISTINE
Other - Middle Name:ANN
Other - Last Name:LEWANDOWSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:210 SPRING GROVE AVE
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43605-1724
Mailing Address - Country:US
Mailing Address - Phone:419-205-7000
Mailing Address - Fax:
Practice Address - Street 1:6805 SYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:SYLVANIA
Practice Address - State:OH
Practice Address - Zip Code:43560-3683
Practice Address - Country:US
Practice Address - Phone:419-882-0029
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-24
Last Update Date:2022-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH02935225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant