Provider Demographics
NPI:1144296385
Name:MINAMYER, GINA MARIE (MSPT)
Entity type:Individual
Prefix:MRS
First Name:GINA
Middle Name:MARIE
Last Name:MINAMYER
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3423 LEDGE LN
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43221-1987
Mailing Address - Country:US
Mailing Address - Phone:614-799-0601
Mailing Address - Fax:614-799-0667
Practice Address - Street 1:5025 BRADENTON AVE
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43017-3506
Practice Address - Country:US
Practice Address - Phone:614-799-0601
Practice Address - Fax:614-799-0667
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH10179225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist