Provider Demographics
NPI:1437501756
Name:GEBBIE, KRISTIN (PT)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:
Last Name:GEBBIE
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 1:82-6066 MAMALAHOA HWY
Mailing Address - Street 2:SUITE #7
Mailing Address - City:CAPTAIN COOK
Mailing Address - State:HI
Mailing Address - Zip Code:96704-8204
Mailing Address - Country:US
Mailing Address - Phone:808-323-8123
Mailing Address - Fax:
Practice Address - Street 1:82-6066 MAMALAHOA HWY
Practice Address - Street 2:SUITE #7
Practice Address - City:CAPTAIN COOK
Practice Address - State:HI
Practice Address - Zip Code:96704-8204
Practice Address - Country:US
Practice Address - Phone:808-323-8123
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-11
Last Update Date:2016-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI3980225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist