Provider Demographics
NPI:1023285715
Name:CALABRESE, CHRISTINA ELIZABETH (PTA)
Entity type:Individual
Prefix:MRS
First Name:CHRISTINA
Middle Name:ELIZABETH
Last Name:CALABRESE
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1426 RAVINE FOREST DR
Mailing Address - Street 2:
Mailing Address - City:WEST BEND
Mailing Address - State:WI
Mailing Address - Zip Code:53090-1052
Mailing Address - Country:US
Mailing Address - Phone:262-438-0076
Mailing Address - Fax:
Practice Address - Street 1:1426 RAVINE FOREST DR
Practice Address - Street 2:
Practice Address - City:WEST BEND
Practice Address - State:WI
Practice Address - Zip Code:53090-1052
Practice Address - Country:US
Practice Address - Phone:262-438-0076
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-12
Last Update Date:2008-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1201-019225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant