National Provider Identifier

Garrett Gibson, PTA

Garrett Gibson, PTA is listed in the NPPES registry with a primary specialty of Physical Therapy Assistant in Fredonia, NY and a listed phone number of (716) 672-4371.

NPI 1306364880Fredonia, NYPhysical Therapy Assistant

Profile Overview

NPI
1306364880
Provider Type
Individual
Primary Specialty
Physical Therapy Assistant
Enumeration Date
September 05, 2017
Last Updated
January 13, 2020

Practice Location

  • 9520 Fredonia Stockton RD
  • Fredonia, NY 14063-9518

Phone: (716) 672-4371

Mailing Address

  • 3824 Route 394
  • Ashville, NY 14710-9749

Specialties

  • Physical Therapy Assistant (225200000X)
Full Record
NPI
1306364880
Entity Type
Individual
Last Name
Gibson
First Name
Garrett
Credential
PTA
Mailing Street Address
3824 Route 394
Mailing City
Ashville
Mailing State
NY
Mailing ZIP Code
14710-9749
Mailing Country
US
Practice Street Address
9520 Fredonia Stockton RD
Practice City
Fredonia
Practice State
NY
Practice ZIP Code
14063-9518
Practice Country
US
Practice Phone
(716) 672-4371
Enumeration Date
September 05, 2017
Last Updated
January 13, 2020
Sex
Male
Sole Proprietor
No
Certification Date
January 13, 2020
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Physical Therapy Assistant (225200000X)