Provider Demographics
NPI:1235366048
Name:GALVO, GERALDINE P (RPT)
Entity Type:Individual
Prefix:MS
First Name:GERALDINE
Middle Name:P
Last Name:GALVO
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 W RAYMOND AVE
Mailing Address - Street 2:
Mailing Address - City:TRAFALGAR
Mailing Address - State:IN
Mailing Address - Zip Code:46181-9311
Mailing Address - Country:US
Mailing Address - Phone:317-441-5703
Mailing Address - Fax:
Practice Address - Street 1:2200 N RILEY HWY
Practice Address - Street 2:
Practice Address - City:SHELBYVILLE
Practice Address - State:IN
Practice Address - Zip Code:46176-9465
Practice Address - Country:US
Practice Address - Phone:317-398-8422
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-18
Last Update Date:2009-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05004227A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist