MEDICARE: GINA KNIGHT PT

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	1162510	TX

General Provider Information

NPI Number	:	1508282880
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GINA KNIGHT PT

Provider Business Mailing Address
First Line	:	333 N SHILOH RD STE 108
Second Line	:
City	:	GARLAND
State	:	TX
Zip	:	75042-6613
Country	:	US
Telephone Number	:	972-256-0566
Fax Number	:	972-276-0586

Provider Business Practice Location Address
First Line	:	333 N SHILOH RD STE 108
Second Line	:
City	:	GARLAND
State	:	TX
Zip	:	75042-6613
Country	:	US
Telephone Number	:	972-256-0566
Fax Number	:	972-276-0586

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

Provider Enumeration Date	:	03/11/2014
Last Update Date	:	03/11/2014

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Directions to “ GINA KNIGHT PT” Practice Location

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