Organization
KIBBEY AND TERLE PT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES ARTHUR KIBBEY, JR PT (OWNER)
(301) 654-7383
Entity
Organization
Contact information
Practice address
5480 WISCONSIN AVE, SUITE B-1, CHEVY CHASE, MD 20815-3530
(301) 654-7383
(301) 654-7897
Mailing address
5480 WISCONSIN AVE, SUITE B-1, CHEVY CHASE, MD 20815-3530
(301) 654-7383
(301) 654-7897
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
KC97
CAREFIRST OF MD GROUP ID
MD
Enumeration date
04/09/2007
Last updated
08/22/2020
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