Provider Demographics
NPI:1063151314
Name:GILBERT, MEG MELISSA (LMBT)
Entity type:Individual
Prefix:
First Name:MEG
Middle Name:MELISSA
Last Name:GILBERT
Suffix:
Gender:F
Credentials:LMBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:169 GILBERT RD
Mailing Address - Street 2:
Mailing Address - City:BENSON
Mailing Address - State:NC
Mailing Address - Zip Code:27504-7537
Mailing Address - Country:US
Mailing Address - Phone:984-222-4799
Mailing Address - Fax:
Practice Address - Street 1:169 GILBERT RD
Practice Address - Street 2:
Practice Address - City:BENSON
Practice Address - State:NC
Practice Address - Zip Code:27504-7537
Practice Address - Country:US
Practice Address - Phone:984-222-4799
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-02
Last Update Date:2022-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC16870225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist