Individual
RICHARD J MCKIBBEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DSC, ECS
Contact information
Practice address
100 A LINDSEY LANE, KINGSLAND, GA 31548-0000
(912) 729-1333
(912) 729-5259
Mailing address
PO BOX 949, ROME, GA 30162-0949
(706) 236-2774
(706) 802-1408
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
PT004832
GA
2251E1300X
Clinical Electrophysiology Physical Therapist
Primary
PT004832
GA
2251E1300X
Clinical Electrophysiology Physical Therapist
PT032925
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
818354932J
—
GA
Enumeration date
10/02/2006
Last updated
06/04/2026
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