Provider Demographics
NPI:1861804312
Name:NICOLE GILBERT PT
Entity type:Organization
Organization Name:NICOLE GILBERT PT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:GILBERT
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:802-343-8792
Mailing Address - Street 1:2804 SHELBURNE FALLS RD
Mailing Address - Street 2:
Mailing Address - City:HINESBURG
Mailing Address - State:VT
Mailing Address - Zip Code:05461-9782
Mailing Address - Country:US
Mailing Address - Phone:802-482-5675
Mailing Address - Fax:
Practice Address - Street 1:2804 SHELBURNE FALLS RD
Practice Address - Street 2:
Practice Address - City:HINESBURG
Practice Address - State:VT
Practice Address - Zip Code:05461-9782
Practice Address - Country:US
Practice Address - Phone:802-482-5675
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-02
Last Update Date:2014-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT040.0002667225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty