Jeffrey Thomas Gillum in Imperial - Sports
Jeffrey Thomas Gillum - NPI 1548235542
Jeffrey Thomas Gillum is a Sports in Imperial, Missouri. Jeffrey Thomas Gillum practices all healthcare services and medical treatments related to Sports. The NPI Number for Jeffrey Thomas Gillum is 1548235542. The last update date is 2007-07-08.
Jeffrey Thomas Gillum's current location address is 1868 Cottonwood Dr, Imperial, Missouri. You can contact this provider via phone number 5737562320 and fax number 5737608677. The mailing address for Jeffrey Thomas Gillum is 1868 Cottonwood Dr, Imperial, Missouri. To know further, please read the information below!
Provider Profile Detail
Provider Name | Jeffrey Thomas Gillum |
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Address | 1868 Cottonwood Dr, Imperial, Missouri |
Phone Number | 5737562320 |
Fax Number | 5737608677 |
Sole Proprietor | X |
Credentials | MPT, ATC |
NPI Number Detail
NPI Number | 1548235542 |
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Provider Enumeration Date | 2006-02-22 |
Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
Address | 1868 Cottonwood Dr |
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City | Imperial |
State | Missouri (MO) |
Post Code | 630521573 |
Phone Number | 5737562320 |
Fax Number | 5737608677 |
Provider's Primary Taxonomy Detail
Speciality | Sports |
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Taxonomy | 2251S0007X |
Licence No | 2003004222 |
Definition: A licensed physical therapist, including but not limited to an individual who is a Board Certified Specialist in Sports Physical Therapy, who has demonstrated specialized knowledge and skill in human anatomy and physiology, movement science, patholog |
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What is the unique 10-digit identifier code issued to Jeffrey Thomas Gillum by the Centers for Medicare & Medicaid Services?
The Jeffrey Thomas Gillum has been assigned the NPI (National Provider Identifier) 1548235542 by the CMS (Centers for Medicare & Medicaid Services). This 10-digit code serves as a unique identification number for healthcare providers.
Could you provide the complete address where Jeffrey Thomas Gillum is physically located?
The Jeffrey Thomas Gillum is situated at the following address: 1868 Cottonwood Dr, Imperial, MO 630521573.
What is the area of specialization for Jeffrey Thomas Gillum, and what is the corresponding taxonomy classification code for this field?
The specialized field of practice for Jeffrey Thomas Gillum is Sports, and the corresponding taxonomy code that categorizes this area of expertise is 2251S0007X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1548235542 to Jeffrey Thomas Gillum?
The Centers for Medicare & Medicaid Services originally issued the 1548235542 to Jeffrey Thomas Gillum on 2006-02-22.
When was the Jeffrey Thomas Gillum's information last updated?
The Jeffrey Thomas Gillum's information was last updated on 2007-07-08.