Provider Demographics
NPI:1841303633
Name:FICK, GINA LYNN (PT, SCD)
Entity type:Individual
Prefix:DR
First Name:GINA
Middle Name:LYNN
Last Name:FICK
Suffix:
Gender:F
Credentials:PT, SCD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4836 GUERNSEY LOOP
Mailing Address - Street 2:
Mailing Address - City:CASTLE ROCK
Mailing Address - State:CO
Mailing Address - Zip Code:80109-7721
Mailing Address - Country:US
Mailing Address - Phone:720-480-2866
Mailing Address - Fax:
Practice Address - Street 1:4836 GUERNSEY LOOP
Practice Address - Street 2:
Practice Address - City:CASTLE ROCK
Practice Address - State:CO
Practice Address - Zip Code:80109-7721
Practice Address - Country:US
Practice Address - Phone:720-480-2866
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2020-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO8901225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO06-6600Medicare Oscar/Certification