MEDICARE: MS. GAIL ANN GERIG

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	1452	CO

General Provider Information

NPI Number	:	1275811309
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. GAIL ANN GERIG

Provider Business Mailing Address
First Line	:	1180 PINE RIDGE RD
Second Line	:
City	:	WOODLAND PARK
State	:	CO
Zip	:	80863-1234
Country	:	US
Telephone Number	:	719-473-3024
Fax Number	:	719-687-9101

Provider Business Practice Location Address
First Line	:	1301 S 8TH ST
Second Line	:	SUITE 110
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80905-7335
Country	:	US
Telephone Number	:	719-473-3024
Fax Number	:	719-687-9101

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/22/2011
Last Update Date	:	07/22/2011

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