Provider Demographics
NPI:1194905802
Name:HUPKA, CHRISTINE M (PT)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:M
Last Name:HUPKA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5080 SPECTRUM DR
Mailing Address - Street 2:SUITE 1200 WEST
Mailing Address - City:ADDISON
Mailing Address - State:TX
Mailing Address - Zip Code:75001-4648
Mailing Address - Country:US
Mailing Address - Phone:800-232-3550
Mailing Address - Fax:
Practice Address - Street 1:500 E 84TH AVE
Practice Address - Street 2:SUITE B-14
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80229-5309
Practice Address - Country:US
Practice Address - Phone:303-287-7070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-09
Last Update Date:2007-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTL-6864225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist