Individual
MR. TRAVIS SHADE GILBERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTA
Contact information
Practice address
3724 JFK BLVD, NORTH LITTLE ROCK, AR 72116-8260
(501) 615-8563
Mailing address
4928 LAKEVIEW RD, NORTH LITTLE ROCK, AR 72116-6727
(214) 681-3424
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OT-A928
AR
Other
Enumeration date
04/03/2023
Last updated
04/03/2023
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