Provider Demographics
NPI:1396178018
Name:GAMBLE, VALERIE CHRISTINE (DPT)
Entity Type:Individual
Prefix:MRS
First Name:VALERIE
Middle Name:CHRISTINE
Last Name:GAMBLE
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:MS
Other - First Name:VALERIE
Other - Middle Name:CHRISTINE
Other - Last Name:HARTLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1001 WEST ST.
Mailing Address - Street 2:
Mailing Address - City:CARTHAGE
Mailing Address - State:NY
Mailing Address - Zip Code:13619
Mailing Address - Country:US
Mailing Address - Phone:315-493-1000
Mailing Address - Fax:315-642-0928
Practice Address - Street 1:32787 US RT 11
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:NY
Practice Address - Zip Code:13673
Practice Address - Country:US
Practice Address - Phone:315-642-0216
Practice Address - Fax:315-642-0928
Is Sole Proprietor?:No
Enumeration Date:2013-08-16
Last Update Date:2016-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY036487225100000X
NY036487-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist