Provider Demographics
NPI:1538561980
Name:MCDEVITT, CHRISTINE S (LMT)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:S
Last Name:MCDEVITT
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 1:1310 E COOKE RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43224-2060
Mailing Address - Country:US
Mailing Address - Phone:614-261-6464
Mailing Address - Fax:
Practice Address - Street 1:3474 N HIGH ST STE D
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-4056
Practice Address - Country:US
Practice Address - Phone:614-261-6464
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-17
Last Update Date:2014-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH33.006766225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist