Provider Demographics
NPI:1710320825
Name:GILBO, DARCY
Entity Type:Individual
Prefix:
First Name:DARCY
Middle Name:
Last Name:GILBO
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 1:40 TIOGA WAY
Mailing Address - Street 2:SUITE 110
Mailing Address - City:MARBLEHEAD
Mailing Address - State:MA
Mailing Address - Zip Code:01945
Mailing Address - Country:US
Mailing Address - Phone:781-631-7444
Mailing Address - Fax:781-639-1175
Practice Address - Street 1:INTEGRATIVE MUSCULAR THERAPY 40 TIOGA WAY
Practice Address - Street 2:SUITE 110
Practice Address - City:MARBLEHEAD
Practice Address - State:MA
Practice Address - Zip Code:01945
Practice Address - Country:US
Practice Address - Phone:781-631-7444
Practice Address - Fax:781-639-1175
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-09
Last Update Date:2013-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2489172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA$$$$$$$$$OtherBC/BS