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General NPI Number Information
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NPI Number | 1255873964
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Entity Type | Organization
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Legal Business Name | CONI GILMAN PHYSICAL THERAPY
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Dates
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Enumeration Date | 11/11/2016
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Last Update Date | 11/11/2016
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Provider Practice Location Address
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Address Line | 68 BRADFORD ST SUITE K
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City | NORTHAMPTON
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State | MA
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Zip | 01060-2537
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Country | US
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Telephone | 413-530-0698
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Fax | 888-411-8532
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Provider Business Mailing Address
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Address Line | 68 BRADFORD ST SUITE K
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City | NORTHAMPTON
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State | MA
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Zip | 01060-2537
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Country | US
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Telephone | 413-530-0698
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Fax | 888-411-8532
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Authorized Official
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Title or Position | PHYSICAL THERAPIST
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Name | CONI L GILMAN
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Credential | P.T.
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Telephone | 413-530-0698
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 15977
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License Number State | MA
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