Provider Demographics
NPI:1992725063
Name:DOTY, GAIL A (PT)
Entity type:Individual
Prefix:
First Name:GAIL
Middle Name:A
Last Name:DOTY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1002 LIVE OAK BLVD
Mailing Address - Street 2:SUITE C
Mailing Address - City:YUBA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95991-4028
Mailing Address - Country:US
Mailing Address - Phone:530-674-9100
Mailing Address - Fax:530-674-9179
Practice Address - Street 1:1002 LIVE OAK BLVD
Practice Address - Street 2:SUITE C
Practice Address - City:YUBA CITY
Practice Address - State:CA
Practice Address - Zip Code:95991-4028
Practice Address - Country:US
Practice Address - Phone:530-674-9100
Practice Address - Fax:530-674-9179
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-20
Last Update Date:2011-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT11171225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist