Individual
LISA R GIBBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AUD
Contact information
Practice address
611 W. PARK ST., AUDIOLOGY, URBANA, IL 61801-2500
(217) 383-3130
Mailing address
611 W. PARK ST., BWPC, URBANA, IL 61801-2500
(217) 383-6941
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
147000511
IL
Other
Enumeration date
04/17/2013
Last updated
12/26/2017
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