Individual
CHRISTINE CONCHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BSPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070.015775
IL
225100000X
Physical Therapist
2006032819
MO
Other
Enumeration date
12/01/2008
Last updated
11/06/2019
Update your record
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