Individual
BRANDON GIBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
112 E 5TH AVE, ANTIGO, WI 54409-2710
(715) 623-9449
Mailing address
6355 N US HIGHWAY 23, SPRUCE, MI 48762-9567
(989) 464-2704
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
5501020235
MI
282N00000X
General Acute Care Hospital
Primary
—
—
Other
Enumeration date
10/07/2021
Last updated
02/18/2022
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