Individual
MISS LYDIA GIBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
220 NW R D MIZE RD STE B203, BLUE SPRINGS, MO 64014-2540
(816) 220-0223
Mailing address
3725 N KANSAS AVE, TOPEKA, KS 66617-1559
(785) 409-0030
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
11-06503
KS
225100000X
Physical Therapist
Primary
2020023285
MO
225200000X
Physical Therapy Assistant
14-02859
KS
Other
Enumeration date
06/08/2015
Last updated
08/06/2020
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