Provider Demographics
NPI:1871802801
Name:WITT, GINNY POPE (PT)
Entity type:Individual
Prefix:
First Name:GINNY
Middle Name:POPE
Last Name:WITT
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 1:1304 ROYAL LN APT 1
Mailing Address - Street 2:
Mailing Address - City:CISCO
Mailing Address - State:TX
Mailing Address - Zip Code:76437-3651
Mailing Address - Country:US
Mailing Address - Phone:254-442-9931
Mailing Address - Fax:254-442-9946
Practice Address - Street 1:1304 ROYAL LN APT 1
Practice Address - Street 2:
Practice Address - City:CISCO
Practice Address - State:TX
Practice Address - Zip Code:76437-3651
Practice Address - Country:US
Practice Address - Phone:254-442-9931
Practice Address - Fax:254-442-9946
Is Sole Proprietor?:No
Enumeration Date:2010-09-24
Last Update Date:2010-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist