Healthcare Provider Details
I. General information
NPI: 1952351108
Provider Name (Legal Business Name): GERALD THOMAS MCGINTY DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 05/10/2006
Last Update Date: 11/25/2024
Certification Date: 11/25/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4102 PINION DR
USAF ACADEMY CO
80840-2502
US
IV. Provider business mailing address
16436 CORKBARK TER
MONUMENT CO
80132-6156
US
V. Phone/Fax
- Phone: 713-640-8186
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2251S0007X |
| Taxonomy | Sports Physical Therapist |
| License Number | PTL.0005129 |
| License Number State | CO |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: