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General NPI Number Information
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NPI Number | 1033497227
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Entity Type | Individual
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Provider Name | MARCEY ANN GIBSON PT
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Gender | Female
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Dates
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Enumeration Date | 07/22/2011
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Last Update Date | 11/10/2011
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Provider Practice Location Address
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Address Line | 400 INDIANA ST STE 280
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City | GOLDEN
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State | CO
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Zip | 80401-5027
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Country | US
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Telephone | 720-398-0999
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Fax |
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Provider Business Mailing Address
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Address Line | 31445 FORESTLAND DR
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City | EVERGREEN
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State | CO
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Zip | 80439-7980
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Country | US
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Telephone | 303-220-7915
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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 | 4755
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License Number State | CO
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