Provider Demographics
NPI:1235616491
Name:GIBBONS, JOSHUA (PT, DPT)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:
Last Name:GIBBONS
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1999 WELLNESS BLVD.
Mailing Address - Street 2:SUITE 220
Mailing Address - City:MONROE
Mailing Address - State:NC
Mailing Address - Zip Code:28110
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1999 WELLNESS BLVD.
Practice Address - Street 2:SUITE 220
Practice Address - City:MONROE
Practice Address - State:NC
Practice Address - Zip Code:28110
Practice Address - Country:US
Practice Address - Phone:704-283-0535
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-20
Last Update Date:2018-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist