Provider Demographics
NPI:1154865343
Name:GILBERT, DAVID S (PT)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:S
Last Name:GILBERT
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2160 SANDY DR STE A
Mailing Address - Street 2:
Mailing Address - City:STATE COLLEGE
Mailing Address - State:PA
Mailing Address - Zip Code:16803-2282
Mailing Address - Country:US
Mailing Address - Phone:814-861-8122
Mailing Address - Fax:814-861-4292
Practice Address - Street 1:2160 SANDY DR STE A
Practice Address - Street 2:
Practice Address - City:STATE COLLEGE
Practice Address - State:PA
Practice Address - Zip Code:16803
Practice Address - Country:US
Practice Address - Phone:814-861-8122
Practice Address - Fax:814-861-4292
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-07
Last Update Date:2018-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT025646225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist