Individual
TIMOTHY J GIBBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, OCS, CERT. MDT
Contact information
Practice address
175 COMMONS LOOP, SUITE 100, KALISPELL, MT 59901-1904
(406) 752-7250
(406) 752-6250
Mailing address
175 COMMONS LOOP, SUITE 100, KALISPELL, MT 59901-1904
(406) 752-7250
(406) 752-6250
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1141PT
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0049348
—
MT
01
—
BCBS OF MT
PROVIDER NUMBER
MT
01
—
MT STATE FUND
PROVIDER NUMBER
MT
01
—
P00380494
RAILROAD MEDICARE
MT
01
—
WA STATE COMP FUND
PROVIDER # FOR WA PATIENT
MT
Enumeration date
10/14/2005
Last updated
01/26/2012
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