Healthcare Provider Details
I. General information
NPI: 1689807943
Provider Name (Legal Business Name): RUBEN GELBIN PT, DPT, MSPT, CSCS
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/02/2009
Last Update Date: 12/16/2024
Certification Date: 12/16/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6237 CAROLINA COMMONS DR STE 110
INDIAN LAND SC
29707-4513
US
IV. Provider business mailing address
4601 PARK RD STE 300
CHARLOTTE NC
28209-2290
US
V. Phone/Fax
- Phone: 803-306-8861
- Fax:
- Phone: 704-323-3611
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | 11244 |
| License Number State | SC |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: