Provider Demographics
NPI:1205920741
Name:LINN, GINA MARIE (LPT)
Entity type:Individual
Prefix:
First Name:GINA
Middle Name:MARIE
Last Name:LINN
Suffix:
Gender:F
Credentials:LPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1317 WHITE DOVE LANE
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76210
Mailing Address - Country:US
Mailing Address - Phone:940-320-7673
Mailing Address - Fax:
Practice Address - Street 1:500 N. VALLEY PARKWAY
Practice Address - Street 2:SUITE 101
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75067-3479
Practice Address - Country:US
Practice Address - Phone:972-434-6600
Practice Address - Fax:972-219-5277
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1139285225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist