Provider Demographics
NPI:1538607858
Name:GILBERT-HOGAN, TERI LYNN (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:TERI
Middle Name:LYNN
Last Name:GILBERT-HOGAN
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:383 CORBIN CENTER DR
Mailing Address - Street 2:
Mailing Address - City:CORBIN
Mailing Address - State:KY
Mailing Address - Zip Code:40701-1895
Mailing Address - Country:US
Mailing Address - Phone:606-526-2909
Mailing Address - Fax:606-526-2901
Practice Address - Street 1:1932 BYPASS RD
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:KY
Practice Address - Zip Code:40391-2389
Practice Address - Country:US
Practice Address - Phone:597-494-0398
Practice Address - Fax:859-757-0088
Is Sole Proprietor?:No
Enumeration Date:2017-02-07
Last Update Date:2020-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY007046225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100447850Medicaid