Individual
ANNETTE GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1975 W ELK AVE, SUITE 1, ELIZABETHTON, TN 37643-3787
(423) 543-0073
(423) 543-1277
Mailing address
1975 W ELK AVE, SUITE 1, ELIZABETHTON, TN 37643-3787
(423) 543-0073
(423) 543-1277
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA0000002636
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0446517
—
TN
Enumeration date
03/05/2007
Last updated
09/09/2016
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