Basic Information
Provider Information
NPI: 1811300809
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CUMMINGS
FirstName: CHRISTINA
MiddleName: MARIE
NamePrefix:  
NameSuffix:  
Credential: PT, DPT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 8823 PRODUCTION LN
Address2:  
City: OOLTEWAH
State: TN
PostalCode: 373636511
CountryCode: US
TelephoneNumber: 4232387217
FaxNumber: 4232383473
Practice Location
Address1: 540 E YOUNG AVE
Address2: STE E
City: WARRENSBURG
State: MO
PostalCode: 640931231
CountryCode: US
TelephoneNumber: 6602624795
FaxNumber: 6607470347
Other Information
ProviderEnumerationDate: 06/06/2014
LastUpdateDate: 03/02/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000XPT011368GAN Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 
225100000XPT9406AZN Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 
225100000X2016037916MOY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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