Individual
BRANDON R GIPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LOTR
Contact information
Practice address
725 MITCHELL LN, SHREVEPORT, LA 71106-2149
(318) 675-0707
Mailing address
5621 GINNY RD, KEITHVILLE, LA 71047-8637
(318) 925-9032
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OTT.200161
LA
Other
Enumeration date
09/01/2007
Last updated
09/01/2007
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