Healthcare Provider Details

I. General information

NPI: 1225391980
Provider Name (Legal Business Name): REBECCA LINN GILBERT PT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/18/2012
Last Update Date: 06/18/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

117 W DUNHAM ST
MADERA CA
93637-5468
US

IV. Provider business mailing address

1127 E WOODHAVEN LN
FRESNO CA
93720-1414
US

V. Phone/Fax

Practice location:
  • Phone: 559-674-0915
  • Fax: 559-661-1228
Mailing address:
  • Phone: 559-674-0915
  • Fax: 559-661-1228

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT14801
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: