Provider Demographics
NPI:1790315901
Name:CHURCHILL, GINGER MCGREGOR (OTR)
Entity Type:Individual
Prefix:
First Name:GINGER
Middle Name:MCGREGOR
Last Name:CHURCHILL
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2910 S GREENFIELD RD APT 3069
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85295-2193
Mailing Address - Country:US
Mailing Address - Phone:480-651-7016
Mailing Address - Fax:
Practice Address - Street 1:2910 S GREENFIELD RD APT 3069
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85295-2193
Practice Address - Country:US
Practice Address - Phone:480-651-7016
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-16
Last Update Date:2020-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist