Individual
TRACEY GIBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1029 E 14 MILE RD, DAFTER, MI 49724-9563
(906) 440-6137
Mailing address
1755 WITTINGTON PL STE 175, DALLAS, TX 75234-1905
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Enumeration date
07/02/2015
Last updated
07/02/2015
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