| Doctor Name: | KACY LEE TIBBETTS |
| NPI Number: | 1386980241 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | DPT |
| License Number: | 4596 |
| Business Practice Address: | 1507 Brookwood Ave Duncan, OK - 735331356 |
| Business Phone Number: | 5802529159 |
| Business Fax Number: | 5802552158 |
| Mailing Address: | 700 Nw 7th St, Suite 302 OKLAHOMA CITY |
| State: | OK |
| Postal Code: | 731021212 |
| Phone Number: | 4056093675 |
| Fax Number: | 8005063795 |
| NPI Enumeration Date: | 12/21/2012 |
| NPI Last Update Date: | 01/08/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 4596 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OK |
| 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 |