Provider Demographics
NPI:1336614460
Name:TYGIELSKI, CHRISTINA (PT, DPT)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:TYGIELSKI
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 RHETT ST APT 114
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29601-5027
Mailing Address - Country:US
Mailing Address - Phone:256-424-3223
Mailing Address - Fax:
Practice Address - Street 1:716 E CEDAR ROCK ST
Practice Address - Street 2:
Practice Address - City:PICKENS
Practice Address - State:SC
Practice Address - Zip Code:29671-2324
Practice Address - Country:US
Practice Address - Phone:864-878-4739
Practice Address - Fax:864-878-1657
Is Sole Proprietor?:No
Enumeration Date:2018-10-04
Last Update Date:2018-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH9008225100000X
SCPT.9323225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist