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Individual

AUSTIN CLARK GIBBS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PT, DPT

Contact information

Practice address
4843 VERDA LN NE APT 202, KEIZER, OR 97303-2364
(503) 583-4017
Mailing address
4843 VERDA LN NE APT 202, KEIZER, OR 97303-2364
(503) 583-4017

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2017026661
MO
225100000X
Physical Therapist
Primary
65957
OR

Other

Enumeration date
05/02/2017
Last updated
01/20/2026
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