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CLINT RAY GIBSON ATC

Athletic Trainer >> Specialist/Technologist >> Respiratory, Developmental, Rehabilitative and Restorative Service Providers

Registrant NPI Number: 1508299868

Individual Registrant:
 CLINT RAY GIBSON ATC
Gender: M
Sole Proprietor

Location and contact information for practice:
STATION #14, UWA  LIVINGSTON, AL 35470 US
Tel: 865-414-4262  Fax: --

Contact information for business:
STATION #14, UWA  LIVINGSTON, AL 35470 US
Tel: 865-414-4262  Fax: --

Registration Information:
NPI: 1508299868
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Specialist/Technologist
Athletic Trainer

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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