Individual
BRIAN C GIBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
153 CENTER RD, VENICE, FL 34285-5572
(941) 488-5553
(941) 218-6596
Mailing address
153 CENTER RD, VENICE, FL 34285-5572
(941) 488-5553
(941) 488-7444
Taxonomy
Speciality
Code
Description
License number
State
111NN1001X
Nutrition Chiropractor
Primary
CH4236
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
U4228
MEDICARE PTAN
FL
Enumeration date
08/18/2006
Last updated
10/10/2017
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