Provider Demographics
NPI:1780029595
Name:GAINESVILLE PHYSICAL THERAPY INCORPORATED
Entity Type:Organization
Organization Name:GAINESVILLE PHYSICAL THERAPY INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:CRISTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:TRYPANIS
Authorized Official - Suffix:
Authorized Official - Credentials:MSPT/DPT
Authorized Official - Phone:703-754-4690
Mailing Address - Street 1:6862 PIEDMONT CENTER PLZ UNIT C5
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20155-4034
Mailing Address - Country:US
Mailing Address - Phone:703-754-4690
Mailing Address - Fax:
Practice Address - Street 1:6862 PIEDMONT CENTER PLZ UNIT C5
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:VA
Practice Address - Zip Code:20155-4034
Practice Address - Country:US
Practice Address - Phone:703-754-4690
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-07
Last Update Date:2015-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty