Provider Demographics
NPI:1497244685
Name:GIBSON, ROWEN M (OTR/L, CLT-LANA, CWT)
Entity type:Individual
Prefix:
First Name:ROWEN
Middle Name:M
Last Name:GIBSON
Suffix:
Gender:M
Credentials:OTR/L, CLT-LANA, CWT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 N GRANT ST UNIT 119
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80203-4488
Mailing Address - Country:US
Mailing Address - Phone:805-704-3052
Mailing Address - Fax:
Practice Address - Street 1:400 N GRANT ST UNIT 119
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80203-4488
Practice Address - Country:US
Practice Address - Phone:805-704-3052
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-03
Last Update Date:2024-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0005402225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist