Provider Demographics
NPI:1831164367
Name:LEVREAULT, CHRISTINE LEE (ATC)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:LEE
Last Name:LEVREAULT
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 DARWIN ST
Mailing Address - Street 2:
Mailing Address - City:WOONSOCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02895-6314
Mailing Address - Country:US
Mailing Address - Phone:401-766-7730
Mailing Address - Fax:
Practice Address - Street 1:20 COLLEGE RD
Practice Address - Street 2:
Practice Address - City:RINDGE
Practice Address - State:NH
Practice Address - Zip Code:03461-5046
Practice Address - Country:US
Practice Address - Phone:603-899-4366
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIAT002052255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer