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Search › Missouri › 225200000X

Trent Gibson

NPI 1538826581 · on the registry since 2021 · sole proprietor

Practice

Address
1 Meramec Bluffs Dr
Ballwin, MO 63021
Phone
(636) 861-0600
Organisation at this address
Lutheran Senior Services
Theodore K Sullivan, Od, Llc
Inferred from a shared address, not stated in the registry.
Clinicians at this address
14

Registry record

Primary taxonomy
225200000X
225200000X
Licence states on file
MO
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2021-11-24

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Missouri