Provider Demographics
NPI:1750399788
Name:REX, GINA M (MPT)
Entity type:Individual
Prefix:MS
First Name:GINA
Middle Name:M
Last Name:REX
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:GINA
Other - Middle Name:M
Other - Last Name:MACMULLAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MPT
Mailing Address - Street 1:224 STRAWBRIDGE DR STE 100
Mailing Address - Street 2:
Mailing Address - City:MOORESTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08057-4602
Mailing Address - Country:US
Mailing Address - Phone:856-677-4000
Mailing Address - Fax:856-234-3014
Practice Address - Street 1:1900 BURLINGTON MOUNT HOLLY RD STE 4C
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08016
Practice Address - Country:US
Practice Address - Phone:609-747-1915
Practice Address - Fax:609-747-8565
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2019-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00916500225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist