Provider Demographics
NPI:1194900894
Name:TARUD, GINA (PT)
Entity type:Individual
Prefix:
First Name:GINA
Middle Name:
Last Name:TARUD
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 1:261 TRAPPER SPRINGS LN
Mailing Address - Street 2:
Mailing Address - City:DRUMS
Mailing Address - State:PA
Mailing Address - Zip Code:18222-1225
Mailing Address - Country:US
Mailing Address - Phone:570-788-7686
Mailing Address - Fax:
Practice Address - Street 1:261 TRAPPER SPRINGS LN
Practice Address - Street 2:
Practice Address - City:DRUMS
Practice Address - State:PA
Practice Address - Zip Code:18222-1225
Practice Address - Country:US
Practice Address - Phone:570-788-7686
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-01
Last Update Date:2008-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT012519L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist