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Individual
MS. SALLIE ANN MCKIBBEN
Active
Individual
MS. SALLIE ANN MCKIBBEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LAC
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC164979
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500696042
—
OR
Enumeration date
05/08/2014
Last updated
07/30/2018
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