Individual
MRS. JUDITH LOUISE GIBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
5125 VICKERY AVE E, TACOMA, WA 98443-2026
(253) 926-8396
Mailing address
5125 VICKERY AVE E, TACOMA, WA 98443-2026
(253) 926-8396
Taxonomy
Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
Primary
MA60126583
WA
Other
Enumeration date
10/02/2010
Last updated
10/04/2010
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