Provider Demographics
NPI:1205878139
Name:GILBERT, SCOTT MICHAEL (DPT)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:MICHAEL
Last Name:GILBERT
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16968 W BELL RD
Mailing Address - Street 2:BUILDING D SUITE 401
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85374-8946
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:16968 W BELL RD
Practice Address - Street 2:BUILDING D SUITE 401
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85374-8946
Practice Address - Country:US
Practice Address - Phone:623-537-9108
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5904174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist