Gibson, Rodney T

Gibson, Rodney T is an sole proprietor health care provider with primary practice located at 146 Northside Dr E , Statesboro GA 30458-1096. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as his primary health care specialty. Gibson, Rodney T can be contacted via phone (912) 764-4141.

Contact Information

Primary practice address
146 Northside Dr E Statesboro GA 30458-1096
Phone: (912) 764-4141
Fax: (912) 764-2247
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X PT002269 Georgia

Profile Details

NPI number 1487748331
LBN Legal business name Gibson, Rodney T
Credentials PT, PED.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 3rd, 2006
Last updated Oct 21st, 2011 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1487748331 NPPES
Georgia MEDICAID 000879623A
Georgia Other 58-1838574
Georgia Other ACS157060500

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