1134386741 NPI number — CRISTINA HART-WOLFE PT, OCS,ATC

Table of content: CRISTINA HART-WOLFE PT, OCS,ATC (NPI 1134386741)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1134386741 NPI number — CRISTINA HART-WOLFE PT, OCS,ATC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HART-WOLFE
Provider First Name:
CRISTINA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PT, OCS,ATC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HART
Provider Other First Name:
CRISTINA
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1134386741
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/21/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3701 E MAIN ST
Provider Second Line Business Mailing Address:
WEATHERFORD REGIONAL HOSPITAL
Provider Business Mailing Address City Name:
WEATHERFORD
Provider Business Mailing Address State Name:
OK
Provider Business Mailing Address Postal Code:
73096-3309
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
580-772-2604
Provider Business Mailing Address Fax Number:
580-772-2906

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3701 E MAIN ST
Provider Second Line Business Practice Location Address:
WEATHERFORD REGIONAL HOSPITAL
Provider Business Practice Location Address City Name:
WEATHERFORD
Provider Business Practice Location Address State Name:
OK
Provider Business Practice Location Address Postal Code:
73096-3309
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
580-772-2604
Provider Business Practice Location Address Fax Number:
580-772-2906
Provider Enumeration Date:
05/21/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2251X0800X , with the licence number:  PT2264 , registered in the state of OK ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)