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Organization
LESLIE K MCKIBBEN RPT ASSOC
Active
Organization
LESLIE K MCKIBBEN RPT ASSOC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LESLIE K MCKIBBEN PT (PRESIDENT)
(321) 259-5592
Entity
Organization
Contact information
Practice address
4640 WHIPPLE HOLLOW RD, MELBOURNE, FL 32934-7661
(321) 259-5592
(321) 259-5592
Mailing address
4640 WHIPPLE HOLLOW RD, MELBOURNE, FL 32934-7661
(321) 259-5592
(321) 259-5592
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
FL5166
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
881511900
—
FL
Enumeration date
10/05/2006
Last updated
04/23/2008
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