Provider Demographics
NPI:1386518843
Name:PERRY, CHRISTINA NICHOLE
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:NICHOLE
Last Name:PERRY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:728 OLD VILLAGE RD
Mailing Address - Street 2:
Mailing Address - City:BLUFFTON
Mailing Address - State:SC
Mailing Address - Zip Code:29909-3960
Mailing Address - Country:US
Mailing Address - Phone:843-415-7585
Mailing Address - Fax:
Practice Address - Street 1:728 OLD VILLAGE RD
Practice Address - Street 2:
Practice Address - City:BLUFFTON
Practice Address - State:SC
Practice Address - Zip Code:29909-3960
Practice Address - Country:US
Practice Address - Phone:843-415-7585
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-30
Last Update Date:2025-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4913225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant