Provider Demographics
NPI:1962026401
Name:MEDEFINDT, GINA M (PT, DPT)
Entity Type:Individual
Prefix:
First Name:GINA
Middle Name:M
Last Name:MEDEFINDT
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:149 FOREST VIEW DR
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27104-3638
Mailing Address - Country:US
Mailing Address - Phone:336-480-4961
Mailing Address - Fax:
Practice Address - Street 1:149 FOREST VIEW DR
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27104-3638
Practice Address - Country:US
Practice Address - Phone:336-480-4961
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-01
Last Update Date:2020-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP19532225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist