Provider Demographics
NPI:1538453675
Name:HARTLE, CHRISTA MARIE (MS OTR/L)
Entity type:Individual
Prefix:
First Name:CHRISTA
Middle Name:MARIE
Last Name:HARTLE
Suffix:
Gender:F
Credentials:MS OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1293 GRANDVIEW RD
Mailing Address - Street 2:
Mailing Address - City:OIL CITY
Mailing Address - State:PA
Mailing Address - Zip Code:16301-1283
Mailing Address - Country:US
Mailing Address - Phone:814-676-8208
Mailing Address - Fax:
Practice Address - Street 1:1293 GRANDVIEW RD
Practice Address - Street 2:
Practice Address - City:OIL CITY
Practice Address - State:PA
Practice Address - Zip Code:16301-1283
Practice Address - Country:US
Practice Address - Phone:814-676-8208
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-07
Last Update Date:2014-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOCO11172225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist