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General NPI Number Information
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NPI Number | 1487831384
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Entity Type | Individual
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Provider Name | GERILYN M GAULT PT
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Gender | Female
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Dates
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Enumeration Date | 01/23/2008
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Last Update Date | 03/21/2024
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Provider Practice Location Address
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Address Line | 236 BURTS RD
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City | KIRKWOOD
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State | NY
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Zip | 13795-1731
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Country | US
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Telephone | 877-426-3307
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Fax | 877-426-3307
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Provider Business Mailing Address
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Address Line | 1868 E BEECHER HILL RD
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City | OWEGO
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State | NY
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Zip | 13827-3815
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Country | US
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Telephone | 607-222-3473
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 012506-1
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License Number State | NY
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