Provider Demographics
NPI:1659526531
Name:GALLIPO, LINDA M (PT)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:M
Last Name:GALLIPO
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:M
Other - Last Name:HANRAHAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:1025 E BROADWAY RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85282-1599
Mailing Address - Country:US
Mailing Address - Phone:480-829-0217
Mailing Address - Fax:480-829-1410
Practice Address - Street 1:1025 E BROADWAY RD
Practice Address - Street 2:SUITE 101
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-1599
Practice Address - Country:US
Practice Address - Phone:480-829-0217
Practice Address - Fax:480-829-1410
Is Sole Proprietor?:No
Enumeration Date:2008-11-19
Last Update Date:2011-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7539225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ7539OtherARIZONA STATE PT LICENSE
AZZ130292Medicare UPIN
AZ03-6596Medicare PIN