Provider Demographics
NPI:1699859363
Name:AUSBUN, GAIL L (MS, RKT, NCTMB, CSSC)
Entity Type:Individual
Prefix:MRS
First Name:GAIL
Middle Name:L
Last Name:AUSBUN
Suffix:
Gender:F
Credentials:MS, RKT, NCTMB, CSSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:613 S IVY WAY
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80224-1208
Mailing Address - Country:US
Mailing Address - Phone:303-807-6816
Mailing Address - Fax:
Practice Address - Street 1:613 S IVY WAY
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80224-1208
Practice Address - Country:US
Practice Address - Phone:303-807-6816
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1484226300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes226300000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersKinesiotherapist