Provider Demographics
NPI:1457794281
Name:GILBERT, JAIME LYN (PTA)
Entity type:Individual
Prefix:MRS
First Name:JAIME
Middle Name:LYN
Last Name:GILBERT
Suffix:
Gender:F
Credentials:PTA
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 153
Mailing Address - Street 2:358 WATER STREET
Mailing Address - City:GUILFORD
Mailing Address - State:ME
Mailing Address - Zip Code:04443
Mailing Address - Country:US
Mailing Address - Phone:207-564-0587
Mailing Address - Fax:
Practice Address - Street 1:358 WATER ST
Practice Address - Street 2:
Practice Address - City:GUILFORD
Practice Address - State:ME
Practice Address - Zip Code:04443-6225
Practice Address - Country:US
Practice Address - Phone:207-564-0587
Practice Address - Fax:207-564-0335
Is Sole Proprietor?:No
Enumeration Date:2013-04-11
Last Update Date:2013-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPA3670225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant