Provider Demographics
NPI:1568474484
Name:GAMBLE, STEVEN K (MS, PT, OCS)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:K
Last Name:GAMBLE
Suffix:
Gender:M
Credentials:MS, PT, OCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 CLINIC DRIVE
Mailing Address - Street 2:
Mailing Address - City:NORWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06360-2915
Mailing Address - Country:US
Mailing Address - Phone:860-887-6408
Mailing Address - Fax:860-887-6592
Practice Address - Street 1:7 CLINIC DRIVE
Practice Address - Street 2:
Practice Address - City:NORWICH
Practice Address - State:CT
Practice Address - Zip Code:06360-2915
Practice Address - Country:US
Practice Address - Phone:860-887-6408
Practice Address - Fax:860-887-6592
Is Sole Proprietor?:No
Enumeration Date:2006-08-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT003827174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist