Christina Michelle79 Ethridge, LMT

Individual provider Active NPI Massage Therapist · White Settlement, TX

NPI 1487024873 · NPPES record last updated Sep 29, 2015

Key facts

NPI
1487024873
Entity type
Individual (NPI type 1)
Primary specialty
Massage Therapist 225700000X
License
MT018910 (TX)
Practice address
8321 White Settlement Rd
White Settlement, TX 76108-1606
Phone
(817) 253-8341
NPI assigned
Sep 29, 2015
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
MT018910TXMDMassage Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X MT018910 TX Yes

Addresses

Primary practice location

8321 White Settlement Rd
White Settlement, TX 76108-1606

Mailing address

8321 White Settlement Rd
White Settlement, TX 76108-1606
Phone (817) 253-8341

Other providers in White Settlement, TX

All providers in White Settlement, TX · Massage Therapist in Texas

Sources for this page

Verify at the official NPI Registry.