Individual
GARRETT GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
9520 FREDONIA STOCKTON RD, FREDONIA, NY 14063-9518
(716) 672-4371
Mailing address
3824 ROUTE 394, ASHVILLE, NY 14710-9749
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
010167-1
NY
Other
Enumeration date
09/05/2017
Last updated
01/13/2020
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