Provider Demographics
NPI:1831471432
Name:GORBY, CHRISTINE M (PT, DPT, SCS, ATC)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:M
Last Name:GORBY
Suffix:
Gender:F
Credentials:PT, DPT, SCS, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 POPLAR HLS
Mailing Address - Street 2:
Mailing Address - City:HURRICANE
Mailing Address - State:WV
Mailing Address - Zip Code:25526-9103
Mailing Address - Country:US
Mailing Address - Phone:330-221-2915
Mailing Address - Fax:
Practice Address - Street 1:29 POPLAR HLS
Practice Address - Street 2:
Practice Address - City:HURRICANE
Practice Address - State:WV
Practice Address - Zip Code:25526-9103
Practice Address - Country:US
Practice Address - Phone:330-221-2915
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-09
Last Update Date:2012-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT 37841174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPT 37841OtherCALIFORNIA STATE LICENSE
FK913ZOtherMEDICARE PTAN