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General NPI Number Information
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NPI Number | 1336258060
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Entity Type | Individual
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Provider Name | GINA SEBRANEK
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Gender | Female
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Dates
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Enumeration Date | 08/29/2006
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Last Update Date | 01/14/2025
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Provider Practice Location Address
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Address Line | 4344 W BELL RD
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City | GLENDALE
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State | AZ
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Zip | 85308-3589
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Country | US
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Telephone | 602-548-9882
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Fax |
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Provider Business Mailing Address
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Address Line | 43909 N 10TH ST
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City | NEW RIVER
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State | AZ
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Zip | 85087-7348
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Country | US
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Telephone | 602-663-7778
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | LPT-002378
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License Number State | AZ
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