Provider Demographics
NPI:1528721578
Name:GILMAN, CHARLES (PT,DPT)
Entity type:Individual
Prefix:
First Name:CHARLES
Middle Name:
Last Name:GILMAN
Suffix:
Gender:M
Credentials:PT,DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 PHYLLIS LN
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:MA
Mailing Address - Zip Code:02038-2871
Mailing Address - Country:US
Mailing Address - Phone:508-277-4340
Mailing Address - Fax:
Practice Address - Street 1:51 PHYLLIS LANE
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:MA
Practice Address - Zip Code:02038-2871
Practice Address - Country:US
Practice Address - Phone:508-277-4340
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-18
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
19517225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist