Provider Demographics
NPI:1588964555
Name:STONE, CHRISTINA L (PTA)
Entity type:Individual
Prefix:MS
First Name:CHRISTINA
Middle Name:L
Last Name:STONE
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3607 N EVERBROOK LN
Mailing Address - Street 2:
Mailing Address - City:MUNCIE
Mailing Address - State:IN
Mailing Address - Zip Code:47304-5220
Mailing Address - Country:US
Mailing Address - Phone:765-741-8390
Mailing Address - Fax:765-741-8219
Practice Address - Street 1:3607 N EVERBROOK LN
Practice Address - Street 2:
Practice Address - City:MUNCIE
Practice Address - State:IN
Practice Address - Zip Code:47304-5220
Practice Address - Country:US
Practice Address - Phone:765-741-8390
Practice Address - Fax:765-741-8219
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-25
Last Update Date:2010-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN06003743A225200000X
IN2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer