Provider Demographics
NPI:1740909985
Name:KREMERS, GABRIELLE LOREE (DPT)
Entity type:Individual
Prefix:DR
First Name:GABRIELLE
Middle Name:LOREE
Last Name:KREMERS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:DR
Other - First Name:GABRIELLE
Other - Middle Name:L
Other - Last Name:BACK-KREMERS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DPT
Mailing Address - Street 1:3484 W WEDINGTON DR STE 4
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72704-7164
Mailing Address - Country:US
Mailing Address - Phone:479-595-0474
Mailing Address - Fax:479-239-5444
Practice Address - Street 1:3484 W WEDINGTON DR STE 4
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72704-7164
Practice Address - Country:US
Practice Address - Phone:479-595-0474
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-23
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR5194225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist