Provider Demographics
NPI:1588791602
Name:SELA, CHRISTINE (LMT, CNMT)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:SELA
Suffix:
Gender:F
Credentials:LMT, CNMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1355 S 8TH ST
Mailing Address - Street 2:SUITE, 203
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80906-7020
Mailing Address - Country:US
Mailing Address - Phone:719-460-5898
Mailing Address - Fax:
Practice Address - Street 1:1355 S 8TH ST
Practice Address - Street 2:SUITE, 203
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80906-7020
Practice Address - Country:US
Practice Address - Phone:719-460-5898
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO130888225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist