Provider Demographics
NPI:1497793848
Name:FITE, GINI ANNE (PTA, ATC)
Entity Type:Individual
Prefix:
First Name:GINI
Middle Name:ANNE
Last Name:FITE
Suffix:
Gender:F
Credentials:PTA, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12814 JAMI CT
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64166-1234
Mailing Address - Country:US
Mailing Address - Phone:816-351-5491
Mailing Address - Fax:
Practice Address - Street 1:2105 KARA CT
Practice Address - Street 2:SUITE 320
Practice Address - City:LIBERTY
Practice Address - State:MO
Practice Address - Zip Code:64068-1392
Practice Address - Country:US
Practice Address - Phone:816-407-1249
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-04
Last Update Date:2016-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS14-01637225200000X
KS24-003872255A2300X
MO2255A2300X, 225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant