Doctor Name: | BRYAN J. GIBBY |
NPI Number: | 1063656221 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MSPT, CWS |
License Number: | 292356-2401 |
Business Practice Address: | 1492 Christensen Dr Blackfoot, ID - 832213707 |
Business Phone Number: | 2082407221 |
Business Fax Number: | |
Mailing Address: | 98 Poplar St, BLACKFOOT |
State: | ID |
Postal Code: | 832211758 |
Phone Number: | 2087853883 |
Fax Number: | |
NPI Enumeration Date: | 04/30/2009 |
NPI Last Update Date: | 04/28/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 292356-2401 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | UT |
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 |