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General NPI Number Information
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NPI Number | 1023330719
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Entity Type | Individual
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Provider Name | SANDRA KAY WRIGHT-GIBSON MPT
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Gender | Female
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Dates
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Enumeration Date | 02/22/2010
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Last Update Date | 02/22/2010
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Provider Practice Location Address
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Address Line | 117 W DUNHAM ST
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City | MADERA
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State | CA
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Zip | 93637-5468
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Country | US
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Telephone | 559-674-0915
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Fax | 559-661-1228
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Provider Business Mailing Address
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Address Line | 42610 YOSEMITE SPRINGS DR
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City | COARSEGOLD
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State | CA
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Zip | 93614-9656
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Country | US
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Telephone | 559-285-2525
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT 22186
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License Number State | CA
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