Provider Demographics
NPI:1467996983
Name:GILBERTSON, KURT (DPT)
Entity Type:Individual
Prefix:
First Name:KURT
Middle Name:
Last Name:GILBERTSON
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 E BENNETT AVE
Mailing Address - Street 2:
Mailing Address - City:GLENDORA
Mailing Address - State:CA
Mailing Address - Zip Code:91741-2641
Mailing Address - Country:US
Mailing Address - Phone:480-298-6351
Mailing Address - Fax:
Practice Address - Street 1:200 E BENNETT AVE
Practice Address - Street 2:
Practice Address - City:GLENDORA
Practice Address - State:CA
Practice Address - Zip Code:91741-2641
Practice Address - Country:US
Practice Address - Phone:480-298-6351
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-19
Last Update Date:2016-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist