Provider Demographics
NPI:1669815577
Name:GILPIN, BOBBIE A
Entity Type:Individual
Prefix:
First Name:BOBBIE
Middle Name:A
Last Name:GILPIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:BOBBIE
Other - Middle Name:A
Other - Last Name:SNIDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1490 DAVIS RD
Mailing Address - Street 2:
Mailing Address - City:ENOSBURG FALLS
Mailing Address - State:VT
Mailing Address - Zip Code:05450-6034
Mailing Address - Country:US
Mailing Address - Phone:802-782-0640
Mailing Address - Fax:
Practice Address - Street 1:303 MAIN ST
Practice Address - Street 2:
Practice Address - City:ENOSBURG
Practice Address - State:VT
Practice Address - Zip Code:05450
Practice Address - Country:US
Practice Address - Phone:802-782-0640
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-10
Last Update Date:2013-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VTCERTIFICATION225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist