Basic Information
| Provider Information | |||||||||
| NPI: | 1053598086 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PUSSER | ||||||||
| FirstName: | CHRISTY | ||||||||
| MiddleName: | LEE | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | OTR/L | ||||||||
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| Mailing Information | |||||||||
| Address1: | 300 BLAKE BLVD | ||||||||
| Address2: | |||||||||
| City: | PINEHURST | ||||||||
| State: | NC | ||||||||
| PostalCode: | 283748474 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9102956158 | ||||||||
| FaxNumber: | 9102950026 | ||||||||
| Practice Location | |||||||||
| Address1: | 300 BLAKE BLVD | ||||||||
| Address2: | |||||||||
| City: | PINEHURST | ||||||||
| State: | NC | ||||||||
| PostalCode: | 283748474 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9102956158 | ||||||||
| FaxNumber: | 9102950026 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/22/2008 | ||||||||
| LastUpdateDate: | 01/22/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | 4530 | NC | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.