Individual
CHRISTINA NOEL REVILLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1041 BRIGHTON AVE, PORTLAND, ME 04102-1042
(207) 699-4111
(207) 773-8814
Mailing address
5191 GLENDALE AVE, HAMBURG, NY 14075-5639
(716) 698-8064
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
050990
NY
225100000X
Physical Therapist
Primary
P23275
NC
225100000X
Physical Therapist
PT6674
ME
Other
Enumeration date
02/26/2024
Last updated
01/27/2025
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