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NPI Code Detail

MEDICARE: BRET GILLESPIE

MEDICARE: BRET GILLESPIE
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
1225100000XPhysical TherapistP18235NC

General Provider Information

NPI Number : 1548748130
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRET GILLESPIE
Provider Business Mailing Address
First Line : 1200 CORPORATE DR STE 400
Second Line :
City : BIRMINGHAM
State : AL
Zip : 35242-5424
Country : US
Telephone Number : 423-682-8840
Fax Number : 423-602-2028
Provider Business Practice Location Address
First Line : 503 OLDE WATERFORD WAY STE 205
Second Line :
City : LELAND
State : NC
Zip : 28451-4148
Country : US
Telephone Number : 910-399-4039
Fax Number : 910-769-2552
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/06/2018
Last Update Date : 08/06/2018

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