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MR. MATTHEW JERRID GIBSON PTA

>> Physical Therapy Assistant >> Respiratory, Developmental, Rehabilitative and Restorative Service Providers

Registrant NPI Number: 1669913737

Individual Registrant:
MR. MATTHEW JERRID GIBSON PTA
Gender: M
Not Sole Proprietor

Location and contact information for practice:
190 CANE HEDGE RD  IRONDALE, AL 35210-3524 US
Tel: 662-571-0093  Fax: --

Contact information for business:
190 CANE HEDGE RD  IRONDALE, AL 35210-3524 US
Tel: 662-571-0093  Fax: --

Registration Information:
NPI: 1669913737
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y225200000XRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Physical Therapy Assistant
MS5561
N225200000XRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Physical Therapy Assistant
TX2117001

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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