Provider Demographics
NPI:1225586837
Name:GILSON, ERIK (LMT)
Entity Type:Individual
Prefix:
First Name:ERIK
Middle Name:
Last Name:GILSON
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:690 FURNACE HILLS PIKE
Mailing Address - Street 2:
Mailing Address - City:LITITZ
Mailing Address - State:PA
Mailing Address - Zip Code:17543-8907
Mailing Address - Country:US
Mailing Address - Phone:717-626-6288
Mailing Address - Fax:
Practice Address - Street 1:690 FURNACE HILLS PIKE
Practice Address - Street 2:
Practice Address - City:LITITZ
Practice Address - State:PA
Practice Address - Zip Code:17543-8907
Practice Address - Country:US
Practice Address - Phone:717-626-6288
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-13
Last Update Date:2016-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMSG011069225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist