MEDICARE: ASHLEIGH DAI GILBERT DPT

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	225100000X	Physical Therapist	P12825	NC
2	225100000X	Physical Therapist	23460	MD
3	2251X0800X	Orthopedic Physical Therapist	2305207626	VA

General Provider Information

NPI Number	:	1770890063
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLEIGH DAI GILBERT DPT

Provider Business Mailing Address
First Line	:	7400 BEAUFONT SPRINGS DR
Second Line	:	SUITE 120
City	:	NORTH CHESTERFIELD
State	:	VA
Zip	:	23225-5556
Country	:	US
Telephone Number	:	804-320-2220
Fax Number	:	804-320-2226

Provider Business Practice Location Address
First Line	:	7400 BEAUFONT SPRINGS DR
Second Line	:	SUITE 120
City	:	NORTH CHESTERFIELD
State	:	VA
Zip	:	23225-5556
Country	:	US
Telephone Number	:	804-320-2220
Fax Number	:	804-320-2226

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

Provider Enumeration Date	:	09/08/2010
Last Update Date	:	05/29/2014

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