Basic Information
| Provider Information | |||||||||
| NPI: | 1598881724 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MCGUIRE | ||||||||
| FirstName: | CHRISTINA | ||||||||
| MiddleName: | LYNN | ||||||||
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| Credential: | PTA | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 822 | ||||||||
| Address2: | |||||||||
| City: | SKELTON | ||||||||
| State: | WV | ||||||||
| PostalCode: | 259190822 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3042540762 | ||||||||
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| Practice Location | |||||||||
| Address1: | 125 SADDLESHOP ROAD | ||||||||
| Address2: | |||||||||
| City: | HILLTOP | ||||||||
| State: | WV | ||||||||
| PostalCode: | 258550125 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3044692966 | ||||||||
| FaxNumber: | 3044692674 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/21/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225200000X | 001122 | WV | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapy Assistant |
No ID Information.