| Doctor Name: | MR. LANCE DEREK GERBER |
| NPI Number: | 1275753469 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PT, DPT, OCS |
| License Number: | PT 00008041 |
| Business Practice Address: | 315 N 14th Ave Physical Therapy Othello, WA - 993441254 |
| Business Phone Number: | 5093312641 |
| Business Fax Number: | |
| Mailing Address: | 315 N 14th Ave, Physical Therapy OTHELLO |
| State: | WA |
| Postal Code: | 993441254 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 04/27/2007 |
| NPI Last Update Date: | 03/29/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2251X0800X |
| License Number: | PT 00008041 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WA |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | Orthopedic |
| Taxonomy Definition: | |