MEDICARE: DR. KEVIN MATTHEW GILBERT D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	3042	MN

General Provider Information

NPI Number	:	1083643670
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KEVIN MATTHEW GILBERT D.C.

Provider Business Mailing Address
First Line	:	1878 CAROL LN
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55118-4533
Country	:	US
Telephone Number	:	651-278-4117
Fax Number	:

Provider Business Practice Location Address
First Line	:	3009 GARFIELD AVE
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55408-2924
Country	:	US
Telephone Number	:	612-823-9355
Fax Number	:	612-827-5049

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/03/2006
Last Update Date	:	07/08/2007

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