MEDICARE: STEPHANIE GAIL GILBERT MSPT

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	5327	AZ

General Provider Information

NPI Number	:	1831140169
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANIE GAIL GILBERT MSPT

Provider Business Mailing Address
First Line	:	7200 W BELL RD
Second Line	:	SUITE F-101
City	:	GLENDALE
State	:	AZ
Zip	:	85308-8529
Country	:	US
Telephone Number	:	623-776-9111
Fax Number	:	623-776-9115

Provider Business Practice Location Address
First Line	:	7200 W BELL RD
Second Line	:	SUITE F-101
City	:	GLENDALE
State	:	AZ
Zip	:	85308-8529
Country	:	US
Telephone Number	:	623-776-9111
Fax Number	:	623-776-9115

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

Provider Enumeration Date	:	05/12/2006
Last Update Date	:	07/09/2007

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