| Doctor Name: | COREY PATRICK GILDEA |
| NPI Number: | 1790133098 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | 25962 |
| Business Practice Address: | 998 Hospitality Way Suite 101 Aberdeen, MD - 210011762 |
| Business Phone Number: | 4102739776 |
| Business Fax Number: | 4102739777 |
| Mailing Address: | 3455 Highway 81, LOGANVILLE |
| State: | GA |
| Postal Code: | 300529138 |
| Phone Number: | 7705540665 |
| Fax Number: | 7705540685 |
| NPI Enumeration Date: | 05/26/2016 |
| NPI Last Update Date: | 05/26/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 25962 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MD |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |