Provider Demographics
NPI:1295936227
Name:CHRISTIE, COLEBURN ALAN SR (PT)
Entity type:Individual
Prefix:MR
First Name:COLEBURN
Middle Name:ALAN
Last Name:CHRISTIE
Suffix:SR
Gender:M
Credentials:PT
Other - Prefix:
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Mailing Address - Street 1:8017 MESA DR
Mailing Address - Street 2:#103
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-1300
Mailing Address - Country:US
Mailing Address - Phone:512-791-3702
Mailing Address - Fax:512-682-0220
Practice Address - Street 1:8017 MESA DR
Practice Address - Street 2:#103
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-1300
Practice Address - Country:US
Practice Address - Phone:512-791-3702
Practice Address - Fax:512-682-0220
Is Sole Proprietor?:No
Enumeration Date:2007-05-29
Last Update Date:2010-01-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TX1135614225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist