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General NPI Number Information
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NPI Number | 1407867039
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Entity Type | Individual
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Provider Name | JESUS GALIMBA
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Gender | Male
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Dates
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Enumeration Date | 08/10/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1010 N DUDNEY RD SUITE D
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City | MAGNOLIA
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State | AR
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Zip | 71753-2624
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Country | US
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Telephone | 870-299-2001
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Fax |
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Provider Business Mailing Address
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Address Line | 557 N JEFFERSON
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City | MAGNOLIA
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State | AR
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Zip | 71753-2806
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Country | US
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Telephone | 870-562-1042
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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 2731
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License Number State | AR
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