Provider Demographics
NPI:1902999204
Name:CHRISTIANSON, DAWN RENEE (PTA)
Entity Type:Individual
Prefix:MRS
First Name:DAWN
Middle Name:RENEE
Last Name:CHRISTIANSON
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:MRS
Other - First Name:DAWN
Other - Middle Name:POLIVKA
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PTA
Mailing Address - Street 1:158 COSGROVE COURT
Mailing Address - Street 2:
Mailing Address - City:FLAT ROCK
Mailing Address - State:NC
Mailing Address - Zip Code:28731
Mailing Address - Country:US
Mailing Address - Phone:828-685-2004
Mailing Address - Fax:
Practice Address - Street 1:2029 A ASHEVILLE HWY
Practice Address - Street 2:PARDEE HOME CARE
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28791
Practice Address - Country:US
Practice Address - Phone:828-277-7113
Practice Address - Fax:828-277-7119
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1313225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant