| Doctor Name: | RICHARD J MCKIBBEN |
| NPI Number: | 1407949134 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PT, DWC, ECS |
| License Number: | PT004832 |
| Business Practice Address: | 100 A Lindsey Lane Kingsland, GA - 315480000 |
| Business Phone Number: | 9127291333 |
| Business Fax Number: | 9127295259 |
| Mailing Address: | Po Box 949, ROME |
| State: | GA |
| Postal Code: | 301620949 |
| Phone Number: | 7062362774 |
| Fax Number: | 7068021408 |
| NPI Enumeration Date: | 10/02/2006 |
| NPI Last Update Date: | 11/10/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2251E1300X |
| License Number: | PT004832 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | GA |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | Electrophysiology, Clinical |
| Taxonomy Definition: | |