Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | 3368 | OR |
N | 225700000X | Massage Therapist | 6990 | OR |
NPI | 1023130473 |
---|---|
Provider Name | Christy Michelle Lang |
First Address | Astoria, OR 97103-6437 |
Second Address | Astoria, OR 97103-6437 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/04/2007 |
Last Update Date | 08/07/2007 |