Provider Demographics
NPI:1871700153
Name:PARISER, GINA LYNNE (PT)
Entity type:Individual
Prefix:DR
First Name:GINA
Middle Name:LYNNE
Last Name:PARISER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5319 MANOR CT
Mailing Address - Street 2:
Mailing Address - City:CRESTWOOD
Mailing Address - State:KY
Mailing Address - Zip Code:40014-8845
Mailing Address - Country:US
Mailing Address - Phone:502-742-1593
Mailing Address - Fax:
Practice Address - Street 1:5319 MANOR CT
Practice Address - Street 2:
Practice Address - City:CRESTWOOD
Practice Address - State:KY
Practice Address - Zip Code:40014-8845
Practice Address - Country:US
Practice Address - Phone:502-742-1593
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY004855225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist