Provider Demographics
NPI:1376536086
Name:CLENNEY, GINA BARBEE (PT)
Entity Type:Individual
Prefix:
First Name:GINA
Middle Name:BARBEE
Last Name:CLENNEY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3431 PLANTATION DR
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:GA
Mailing Address - Zip Code:31721-2032
Mailing Address - Country:US
Mailing Address - Phone:229-878-3462
Mailing Address - Fax:229-889-1646
Practice Address - Street 1:3431 PLANTATION DR
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:GA
Practice Address - Zip Code:31721-2032
Practice Address - Country:US
Practice Address - Phone:229-878-3462
Practice Address - Fax:229-889-1646
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA3656225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA65BBCLCMedicare ID - Type Unspecified