Individual
MEGAN OLIVIA GIBB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
449 S FITNESS PL, EAGLE, ID 83616-6828
(208) 957-6301
Mailing address
1816 N 14TH ST, BOISE, ID 83702-2605
(208) 571-2083
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTAL-2994
ID
Other
Enumeration date
06/24/2024
Last updated
06/24/2024
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