Provider Demographics
NPI:1588970099
Name:LEFKO, CHRISTINE M (DPT)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:M
Last Name:LEFKO
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:CHRISTINE
Other - Middle Name:M
Other - Last Name:LEFKO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:85083 CHRISTIAN WAY APT 518
Mailing Address - Street 2:
Mailing Address - City:YULEE
Mailing Address - State:FL
Mailing Address - Zip Code:32097-3407
Mailing Address - Country:US
Mailing Address - Phone:904-716-0573
Mailing Address - Fax:
Practice Address - Street 1:45390 GREEN AVE
Practice Address - Street 2:
Practice Address - City:CALLAHAN
Practice Address - State:FL
Practice Address - Zip Code:32011-3711
Practice Address - Country:US
Practice Address - Phone:904-879-1223
Practice Address - Fax:904-879-4986
Is Sole Proprietor?:No
Enumeration Date:2010-08-20
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL23345225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist