Organization
KELLY GIBSONCHIROPRACTIC, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KELLY MARIE GIBSON D.C. (PRESIDENT)
(760) 724-5700
Entity
Organization
Contact information
Practice address
1929 W VISTA WAY, SUITE C, VISTA, CA 92083-6004
(760) 724-5700
(760) 724-9878
Mailing address
1929 W VISTA WAY, SUITE C, VISTA, CA 92083-6004
(760) 724-5700
(760) 724-9878
Taxonomy
Speciality
Code
Description
License number
State
111NI0900X
Internist Chiropractor
Primary
DC25328
CA
111NN1001X
Nutrition Chiropractor
DC25328
CA
111NR0400X
Rehabilitation Chiropractor
DC25328
CA
111NS0005X
Sports Physician Chiropractor
DC10902
CA
Other
Enumeration date
01/31/2017
Last updated
01/31/2017
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