Provider Demographics
NPI:1861788051
Name:BELCHER, CHRISTINA WEIDNER (PT, DPT)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:WEIDNER
Last Name:BELCHER
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:CHRISTINA
Other - Middle Name:RENEE
Other - Last Name:WEIDNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:1246 PINE ST
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30901-3335
Mailing Address - Country:US
Mailing Address - Phone:478-607-1070
Mailing Address - Fax:705-550-6178
Practice Address - Street 1:1246 PINE ST
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30901
Practice Address - Country:US
Practice Address - Phone:478-607-1070
Practice Address - Fax:706-550-6178
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-25
Last Update Date:2021-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC6211225100000X
GAPT010298225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCTH 2383Medicaid
GA003110206BMedicaid
GA003110206AMedicaid