Doctor Name: | KELLY GIBSON |
NPI Number: | 1023388444 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MPT |
License Number: | 7940 |
Business Practice Address: | 701 Hewitt Blvd Red Wing, MN - 550662848 |
Business Phone Number: | 6512675457 |
Business Fax Number: | 6512675946 |
Mailing Address: | 701 Hewitt Blvd, RED WING |
State: | MN |
Postal Code: | 550662848 |
Phone Number: | 6512675457 |
Fax Number: | 6512675946 |
NPI Enumeration Date: | 01/02/2012 |
NPI Last Update Date: | 10/22/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 7940 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MN |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |