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NPI Code Detail

MEDICARE: BRENT EDWARD GERBIG PTA

MEDICARE: BRENT EDWARD GERBIG PTA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225200000XPhysical Therapy Assistant32504FL

General Provider Information

NPI Number : 1932885308
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRENT EDWARD GERBIG PTA
Provider Business Mailing Address
First Line : 139 PALM GROVE BLVD
Second Line : NONE
City : PANAMA CITY BEACH
State : FL
Zip : 32408
Country : US
Telephone Number : 937-689-9923
Fax Number :
Provider Business Practice Location Address
First Line : 401 N ALF COLEMAN RD
Second Line :
City : PANAMA CITY BEACH
State : FL
Zip : 32407-2567
Country : US
Telephone Number : 850-749-5020
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/22/2023
Last Update Date : 06/22/2023

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Directions to “ BRENT EDWARD GERBIG PTA” Practice Location

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