Individual
JENNA KIBBON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
2700 E 12TH ST, CHEYENNE, WY 82001-5604
(307) 634-7986
Mailing address
2700 E 12TH ST, CHEYENNE, WY 82001-5604
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1519
WY
225100000X
Physical Therapist
2336
NE
Other
Enumeration date
01/23/2014
Last updated
01/23/2014
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