Individual
MRS. DERENDA JEAN GIBBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
17374 CLEARWATER DR, HENSLEY, AR 72065-8068
(501) 888-4850
Mailing address
17374 CLEARWATER DR, HENSLEY, AR 72065-8068
(501) 888-4850
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
726
AR
Other
Enumeration date
03/21/2007
Last updated
07/09/2007
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