Provider Demographics
NPI:1114123361
Name:GILBERT, MICHAEL M (DPT)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:M
Last Name:GILBERT
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:103 SWEETBRIAR LN
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:PA
Mailing Address - Zip Code:17046-8127
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5425 JONESTOWN RD
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17112-4086
Practice Address - Country:US
Practice Address - Phone:717-901-9487
Practice Address - Fax:717-901-9488
Is Sole Proprietor?:No
Enumeration Date:2007-06-25
Last Update Date:2010-03-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAPT018718225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAPT018718Medicare Oscar/Certification