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General NPI Number Information
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NPI Number | 1790725422
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Entity Type | Individual
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Provider Name | GINGER GIBSON P.T.
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Gender | Female
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Dates
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Enumeration Date | 06/08/2006
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Last Update Date | 02/07/2020
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Provider Practice Location Address
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Address Line | 118 GRACELAND BLVD STE 327
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City | COLUMBUS
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State | OH
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Zip | 43214-1530
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Country | US
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Telephone | 877-967-5769
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Fax |
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Provider Business Mailing Address
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Address Line | 118 GRACELAND BLVD STE 327
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City | COLUMBUS
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State | OH
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Zip | 43214-1530
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Country | US
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Telephone | 312-399-4090
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Fax | 877-967-5759
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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 | 070016321
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT011193
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License Number State | OH
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