Provider Demographics
NPI:1841421005
Name:GILBERT, CANDICE N (MPT)
Entity Type:Individual
Prefix:MRS
First Name:CANDICE
Middle Name:N
Last Name:GILBERT
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:MRS
Other - First Name:CANDICE
Other - Middle Name:NICOLE
Other - Last Name:BRADLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MPT
Mailing Address - Street 1:667 POLICE TOWER RD
Mailing Address - Street 2:
Mailing Address - City:APPOMATTOX
Mailing Address - State:VA
Mailing Address - Zip Code:24522-5344
Mailing Address - Country:US
Mailing Address - Phone:434-229-2700
Mailing Address - Fax:
Practice Address - Street 1:667 POLICE TOWER RD
Practice Address - Street 2:
Practice Address - City:APPOMATTOX
Practice Address - State:VA
Practice Address - Zip Code:24522-5344
Practice Address - Country:US
Practice Address - Phone:434-229-2700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-05
Last Update Date:2009-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305203773225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist