Provider Demographics
NPI:1710136387
Name:WEEKS, GINA MARIA (PT, DPT)
Entity Type:Individual
Prefix:MS
First Name:GINA
Middle Name:MARIA
Last Name:WEEKS
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:GINA
Other - Middle Name:MARIA
Other - Last Name:BASSO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3515 GLENWOOD AVE
Mailing Address - Street 2:RALEIGH ORTHOPAEDIC REHAB SPECIALISTS
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27612
Mailing Address - Country:US
Mailing Address - Phone:919-863-6996
Mailing Address - Fax:
Practice Address - Street 1:700 3RD ST
Practice Address - Street 2:SUITE 202
Practice Address - City:NEPTUNE BEACH
Practice Address - State:FL
Practice Address - Zip Code:32266-5072
Practice Address - Country:US
Practice Address - Phone:904-249-5020
Practice Address - Fax:904-241-7777
Is Sole Proprietor?:No
Enumeration Date:2008-09-18
Last Update Date:2019-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL24179225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist