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General NPI Number Information
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NPI Number | 1639038656
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Entity Type | Individual
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Provider Name | BRAYDON GIBSON DC
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Gender | Male
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Dates
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Enumeration Date | 01/16/2026
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Last Update Date | 01/16/2026
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Provider Practice Location Address
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Address Line | 610 E PARK AVE
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City | COLUMBIANA
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State | OH
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Zip | 44408-1431
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Country | US
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Telephone | 330-482-2556
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Fax |
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Provider Business Mailing Address
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Address Line | 610 E PARK AVE
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City | COLUMBIANA
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State | OH
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Zip | 44408-1431
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Country | US
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Telephone | 330-482-2556
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | DC-05508
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License Number State | OH
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