Provider Demographics
NPI:1447261482
Name:DANA, CHRISTINE (PT)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:DANA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 TURTLE CREEK DR
Mailing Address - Street 2:SOUTHEASTERN PHYSICAL THERAPY, LLC
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803-3152
Mailing Address - Country:US
Mailing Address - Phone:828-274-2188
Mailing Address - Fax:
Practice Address - Street 1:23 TURTLE CREEK DR
Practice Address - Street 2:SOUTHEASTERN FITNESS AND REHAB
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-3152
Practice Address - Country:US
Practice Address - Phone:828-274-2188
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2016-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0400002212225100000X
NC11206225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
4420539OtherAETNA
43014OtherMVP
VTOVN2138Medicaid
00005897OtherBCBS OF VT
DAVN2138Medicare ID - Type Unspecified