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General NPI Number Information
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NPI Number | 1619256559
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Entity Type | Individual
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Provider Name | DAVID MICHAEL BIBBEY O.M.
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Gender | Male
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Dates
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Enumeration Date | 08/09/2011
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Last Update Date | 09/19/2017
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Provider Practice Location Address
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Address Line | 441 SE KINGS BAY DR
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City | CRYSTAL RIVER
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State | FL
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Zip | 34429-4717
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Country | US
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Telephone | 352-464-1645
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Fax | 352-628-0769
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Provider Business Mailing Address
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Address Line | 441 SE KINGS BAY DR
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City | CRYSTAL RIVER
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State | FL
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Zip | 34429-4717
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Country | US
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Telephone | 352-464-1645
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Fax | 352-794-6010
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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 | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AP 3005
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License Number State | FL
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