Provider Demographics
NPI:1740504950
Name:GJG THERAPY SERVICES
Entity type:Organization
Organization Name:GJG THERAPY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:GABELMAN
Authorized Official - Suffix:III
Authorized Official - Credentials:PTA
Authorized Official - Phone:561-676-6534
Mailing Address - Street 1:116 SEA PLUM DR APT 101
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-6315
Mailing Address - Country:US
Mailing Address - Phone:561-676-6534
Mailing Address - Fax:
Practice Address - Street 1:116 SEA PLUM DR APT 101
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-6315
Practice Address - Country:US
Practice Address - Phone:561-676-6534
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-16
Last Update Date:2010-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPTA 20846225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy AssistantGroup - Single Specialty