Individual
JACQUELINE MACGIBBON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD LD
Contact information
Practice address
2000 HAMILTON ST, SUITE 303, PHILADELPHIA, PA 19130-3814
(215) 564-4880
(215) 564-4890
Mailing address
2000 HAMILTON ST, SUITE 303, PHILADELPHIA, PA 19130-3814
(215) 564-4880
(215) 564-4890
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DN004129
PA
Other
Enumeration date
09/13/2010
Last updated
09/13/2010
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