Provider Demographics
NPI:1932144284
Name:TARLETON, GAIL M (PT)
Entity Type:Individual
Prefix:
First Name:GAIL
Middle Name:M
Last Name:TARLETON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2750 WILLOW OAK CIR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22901-9526
Mailing Address - Country:US
Mailing Address - Phone:434-293-9781
Mailing Address - Fax:540-943-9602
Practice Address - Street 1:111 MONTICELLO AVE
Practice Address - Street 2:SUITE B
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22902-5660
Practice Address - Country:US
Practice Address - Phone:434-817-4276
Practice Address - Fax:434-817-4277
Is Sole Proprietor?:No
Enumeration Date:2006-06-19
Last Update Date:2008-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305004628225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA017605P25Medicare PIN