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NPI Code Detail

MEDICARE: DESIREE GIBBS PT

MEDICARE: DESIREE GIBBS PT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist

General Provider Information

NPI Number : 1386885937
Entity Type Code : Individual
Provider Name (Legal Business Name) : DESIREE GIBBS PT
Provider Business Mailing Address
First Line : 50 VREELAND DRIVE
Second Line : BUILDING 50, SUITE 4, MONTGOMERY PROFESSIONAL CENTER
City : SKILLMAN
State : NJ
Zip : 08558-1404
Country : US
Telephone Number : 609-924-6800
Fax Number :
Provider Business Practice Location Address
First Line : 50 VREELAND DR
Second Line : BUILDING 50, SUITE 4, MONTGOMERY PROFESSIONAL CENTER
City : SKILLMAN
State : NJ
Zip : 08558-2639
Country : US
Telephone Number : 609-924-6800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/11/2009
Last Update Date : 12/29/2015

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