Individual
CARL EDWARD GIBSON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPT
Contact information
Practice address
1330 BOILING SPRINGS RD, SUITE 1600B, SPARTANBURG, SC 29303-4201
(864) 582-0019
Mailing address
1330 BOILING SPRINGS RD, SUITE 1600B, SPARTANBURG, SC 29303-4201
(864) 582-0019
(864) 582-2160
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
109
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
109
SC STATE LICENSE
SC
01
—
8438
GROUP MEDICARE
SC
Enumeration date
05/21/2008
Last updated
04/13/2010
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