Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 11851 | AZ |
N | 2251X0800X | Physical Therapist - Orthopedic | 20031 | MD |
N | 2251X0800X | Physical Therapist - Orthopedic | J10001602 | DE |
NPI | 1033206370 |
---|---|
Provider Name | Cristina Rayne Madarang-Stofik |
First Address | Bolingbrook, IL 60440-4909 |
Second Address | Phoenix, AZ 85022-6640 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/10/2006 |
Last Update Date | 22/08/2017 |