Provider Demographics
NPI:1003477274
Name:GILBERTSON, BRIDGET (PT, DPT)
Entity type:Individual
Prefix:
First Name:BRIDGET
Middle Name:
Last Name:GILBERTSON
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:SWORD HEALTH INC., 13937 SPRAGUE LANE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:DRAPER
Mailing Address - State:UT
Mailing Address - Zip Code:84020
Mailing Address - Country:US
Mailing Address - Phone:385-308-8034
Mailing Address - Fax:
Practice Address - Street 1:2931 N MAYWOOD AVE
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83704-5681
Practice Address - Country:US
Practice Address - Phone:385-498-1740
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-27
Last Update Date:2024-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLTPPT370225100000X
CA3056942251X0800X
OHPT0209712251X0800X
PAPT0321142251X0800X
NY0518762251X0800X
TX13901402251X0800X
IL0700281442251X0800X
ID62482251X0800X
ALPTH11831225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist