Organization
GINA THE PT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GINA JELACIC MPT (PHYSICAL THERAPIST)
(970) 688-1433
Entity
Organization
Contact information
Practice address
5177 BLACK GORE DR, UNIT B1, VAIL, CO 81657-5273
(970) 688-1433
Mailing address
5177 BLACK GORE DR, UNIT B1, VAIL, CO 81657-5273
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
09/14/2006
Last updated
10/02/2007
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