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Individual

GABRIELLE FAITH BIRT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
5255 E MARYLAND ST, DECATUR, IL 62521-9705
(217) 864-1264
Mailing address
PO BOX 416501, BOSTON, MA 02241-7594
(914) 294-4050
(631) 760-8306

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070029294
IL

Other

Enumeration date
06/23/2025
Last updated
03/26/2026
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