Provider Demographics
NPI:1689609984
Name:FRANKLIN-PERRY, GAIL J (PT)
Entity Type:Individual
Prefix:MS
First Name:GAIL
Middle Name:J
Last Name:FRANKLIN-PERRY
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 1:4040 POLLED HEREFORD DR
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95404-6251
Mailing Address - Country:US
Mailing Address - Phone:707-292-1076
Mailing Address - Fax:
Practice Address - Street 1:4040 POLLED HEREFORD DR
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95404-6251
Practice Address - Country:US
Practice Address - Phone:707-292-1076
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2018-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA10260225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAOPT102600Medicare ID - Type Unspecified