Provider Demographics
NPI:1821645318
Name:CASTLE, GINGER LYNN (LMT CKTP CNRT-M)
Entity Type:Individual
Prefix:
First Name:GINGER
Middle Name:LYNN
Last Name:CASTLE
Suffix:
Gender:F
Credentials:LMT CKTP CNRT-M
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4809 W CHEETAH ST
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85742-8900
Mailing Address - Country:US
Mailing Address - Phone:520-977-9938
Mailing Address - Fax:
Practice Address - Street 1:3444 N COUNTRY CLUB RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85716-1200
Practice Address - Country:US
Practice Address - Phone:520-977-9938
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-20
Last Update Date:2019-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZMT-04527P225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist