Provider Demographics
NPI:1720010770
Name:GERSTEL, DAVID L (PT)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:L
Last Name:GERSTEL
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:810 ARCTURUS DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80905-7846
Mailing Address - Country:US
Mailing Address - Phone:719-444-0381
Mailing Address - Fax:719-444-0218
Practice Address - Street 1:810 ARCTURUS DR
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80905-7846
Practice Address - Country:US
Practice Address - Phone:719-444-0381
Practice Address - Fax:719-444-0218
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2016-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5746225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO803710Medicare ID - Type Unspecified