Provider Demographics
NPI:1871343863
Name:PUGLIESE, CHRISTINA (LMT)
Entity type:Individual
Prefix:MRS
First Name:CHRISTINA
Middle Name:
Last Name:PUGLIESE
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:414 S 3RD ST
Mailing Address - Street 2:
Mailing Address - City:MONTROSE
Mailing Address - State:CO
Mailing Address - Zip Code:81401-4204
Mailing Address - Country:US
Mailing Address - Phone:509-570-2223
Mailing Address - Fax:
Practice Address - Street 1:611 S HILLCREST DR STE B
Practice Address - Street 2:
Practice Address - City:MONTROSE
Practice Address - State:CO
Practice Address - Zip Code:81401-4469
Practice Address - Country:US
Practice Address - Phone:509-570-2223
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-25
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0024809225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist