Provider Demographics
NPI:1285051938
Name:GEBO-WILBER, TAMERA S (PHYSICAL THERAPIST)
Entity type:Individual
Prefix:
First Name:TAMERA
Middle Name:S
Last Name:GEBO-WILBER
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 30
Mailing Address - Street 2:444 STOCKBRIDGE ROAD
Mailing Address - City:GREAT BARRINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01230-0030
Mailing Address - Country:US
Mailing Address - Phone:412-528-8580
Mailing Address - Fax:413-528-8583
Practice Address - Street 1:444 STOCKBRIDGE ROAD
Practice Address - Street 2:
Practice Address - City:GREAT BARRINGTON
Practice Address - State:MA
Practice Address - Zip Code:01230
Practice Address - Country:US
Practice Address - Phone:412-528-8580
Practice Address - Fax:413-528-8583
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-19
Last Update Date:2014-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA6718225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist