| Doctor Name: | CHRISTY MARILO |
| NPI Number: | 1003102112 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PT,MPT,PCS |
| License Number: | PT20124 |
| Business Practice Address: | 233 Orangefair Mall Fullerton, CA - 928323038 |
| Business Phone Number: | 7148706116 |
| Business Fax Number: | 7148709038 |
| Mailing Address: | 233 Orangefair Mall, FULLERTON |
| State: | CA |
| Postal Code: | 928323038 |
| Phone Number: | 7148706116 |
| Fax Number: | 7148709038 |
| NPI Enumeration Date: | 06/27/2011 |
| NPI Last Update Date: | 06/27/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2251P0200X |
| License Number: | PT20124 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | Pediatrics |
| Taxonomy Definition: | |