Provider Demographics
NPI:1194948224
Name:PERRY GILBERTSON, RACHEL L (LMT)
Entity type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:L
Last Name:PERRY GILBERTSON
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:229 E SHERMAN RD
Mailing Address - Street 2:
Mailing Address - City:EDGERTON
Mailing Address - State:WI
Mailing Address - Zip Code:53534-9003
Mailing Address - Country:US
Mailing Address - Phone:608-884-8833
Mailing Address - Fax:608-884-8383
Practice Address - Street 1:229 E SHERMAN RD
Practice Address - Street 2:
Practice Address - City:EDGERTON
Practice Address - State:WI
Practice Address - Zip Code:53534-9003
Practice Address - Country:US
Practice Address - Phone:608-884-8833
Practice Address - Fax:608-884-8383
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2009-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI619-046225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist