Provider Demographics
NPI:1932590015
Name:GILBERT, DAVID WATSON (LMT)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:WATSON
Last Name:GILBERT
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3213 W CHARLESTON BLVD STE 105
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89102-1991
Mailing Address - Country:US
Mailing Address - Phone:702-570-6222
Mailing Address - Fax:
Practice Address - Street 1:3213 W CHARLESTON BLVD STE 105
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-1991
Practice Address - Country:US
Practice Address - Phone:702-570-6222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-11
Last Update Date:2015-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVNVMT-6853225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist