Provider Demographics
NPI:1326024530
Name:GILLANDERS, ROBERT (DPT)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:GILLANDERS
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2175 K ST NW
Mailing Address - Street 2:ORTHOLOGY STE C-120
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20037-1831
Mailing Address - Country:US
Mailing Address - Phone:202-463-7611
Mailing Address - Fax:202-463-7669
Practice Address - Street 1:2021 K ST NW
Practice Address - Street 2:SPORTS AND SPINAL PHYSICAL THEAPY SUITE 500
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20006-1003
Practice Address - Country:US
Practice Address - Phone:202-463-7611
Practice Address - Fax:202-463-7669
Is Sole Proprietor?:No
Enumeration Date:2005-12-20
Last Update Date:2016-01-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA2305006263225100000X
DCPT870954225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCQ41413Medicare UPIN
DC016874J86Medicare PIN