Provider Demographics
NPI:1831140169
Name:GILBERT, STEPHANIE GAIL (MSPT)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:GAIL
Last Name:GILBERT
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:GAIL
Other - Last Name:STROH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSPT
Mailing Address - Street 1:7200 W BELL RD
Mailing Address - Street 2:SUITE F-101
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-8529
Mailing Address - Country:US
Mailing Address - Phone:623-776-9111
Mailing Address - Fax:623-776-9115
Practice Address - Street 1:7200 W BELL RD
Practice Address - Street 2:SUITE F-101
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-8529
Practice Address - Country:US
Practice Address - Phone:623-776-9111
Practice Address - Fax:623-776-9115
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-12
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5327225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ109211Medicare PIN