Provider Demographics
NPI:1467539239
Name:GILBERT, SUSANNE D
Entity Type:Individual
Prefix:
First Name:SUSANNE
Middle Name:D
Last Name:GILBERT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8389 S INDEPENDENCE CIR
Mailing Address - Street 2:#101
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80128-9254
Mailing Address - Country:US
Mailing Address - Phone:720-270-4730
Mailing Address - Fax:
Practice Address - Street 1:8389 S INDEPENDENCE CIR
Practice Address - Street 2:#101
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80128-9254
Practice Address - Country:US
Practice Address - Phone:720-270-4730
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2008-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO7248225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO7248OtherPHYSICAL THERAPIST LICENS
COC477678Medicare PIN