Carrie Mae Chu Cristobal, PT, DPT
Individual provider Active NPI Physical Therapist · Belfry, KY
NPI 1194320754 · NPPES record last updated Dec 2, 2020
Key facts
- NPI
- 1194320754
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 003720 (WV)
- Practice address
- 26901 US Highway 119 N
Belfry, KY 41514-7520 - Phone
- (606) 237-1460
- NPI assigned
- Dec 2, 2020
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 003720 | WV | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 003720 | WV | Yes |
Addresses
Primary practice location
26901 US Highway 119 N
Belfry, KY 41514-7520
Mailing address
14 Peach Creek Rd (PO Box 414)
Apt. 2
Peach Creek, WV 25639
Phone (681) 222-4100
Other providers in Belfry, KY
- Gabriel Brian Carrillo
- Shelby Carter
- Annette Chafin
- Christina Marie Coleman
- Brittany Cooper
- Erica Lee-Ann Dillon
- Lariza Mae Fernando
- Patricia Gail Fields
- Andrew Francis
- Tina G. Gaunt
All providers in Belfry, KY · Physical Therapist in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 2, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.