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General NPI Number Information
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NPI Number | 1396229092
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Entity Type | Individual
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Provider Name | CHRISTOPHER JOHN GILBERT LMT
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Gender | Male
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Dates
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Enumeration Date | 09/18/2018
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Last Update Date | 09/18/2018
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Provider Practice Location Address
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Address Line | 4039 CARPENTER RD
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City | YPSILANTI
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State | MI
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Zip | 48197-9272
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Country | US
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Telephone | 734-677-0111
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Fax |
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Provider Business Mailing Address
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Address Line | 1836 GEORGE AVE
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City | YPSILANTI
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State | MI
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Zip | 48198-6663
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Country | US
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Telephone | 734-787-3383
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 7501008402
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License Number State | MI
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