Provider Demographics
NPI:1710083712
Name:GENTILINI, GINA MARIE (DC)
Entity Type:Individual
Prefix:DR
First Name:GINA
Middle Name:MARIE
Last Name:GENTILINI
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1190 E BRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:CO
Mailing Address - Zip Code:80601-2233
Mailing Address - Country:US
Mailing Address - Phone:303-659-4220
Mailing Address - Fax:303-659-1832
Practice Address - Street 1:429 E BRIDGE ST
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:CO
Practice Address - Zip Code:80601-2101
Practice Address - Country:US
Practice Address - Phone:303-659-4220
Practice Address - Fax:303-659-1832
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2017-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4768111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
COU75550Medicare UPIN
COC389208Medicare ID - Type UnspecifiedGROUP PROVIDER NUMBER
COC389128Medicare PIN