MEDICARE: DEBORAH L GILMORE CNMT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	172M00000X	Mechanotherapist

General Provider Information

NPI Number	:	1285805366
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEBORAH L GILMORE CNMT

Provider Business Mailing Address
First Line	:	1016 S TAFT HILL RD
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80521-4223
Country	:	US
Telephone Number	:	970-227-5162
Fax Number	:

Provider Business Practice Location Address
First Line	:	1016 S TAFT HILL RD
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80521-4223
Country	:	US
Telephone Number	:	970-227-5162
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/17/2008
Last Update Date	:	03/17/2008

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