Provider Demographics
NPI:1306139563
Name:HILLMAN, GAVIN C (DPT)
Entity type:Individual
Prefix:DR
First Name:GAVIN
Middle Name:C
Last Name:HILLMAN
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2050 W WARM SPRINGS RD
Mailing Address - Street 2:UNIT 821
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89014-5524
Mailing Address - Country:US
Mailing Address - Phone:505-250-8461
Mailing Address - Fax:
Practice Address - Street 1:2050 W WARM SPRINGS RD
Practice Address - Street 2:UNIT 821
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89014-5524
Practice Address - Country:US
Practice Address - Phone:505-250-8461
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-20
Last Update Date:2011-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV2447225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist