Individual
MR. JOHN F KIBBY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
2110 PRIEST BRIDGE DR, SUITE 6, CROFTON, MD 21114-2472
(410) 721-5050
(301) 858-1608
Mailing address
2110 PRIEST BRIDGE DR, SUITE 6, CROFTON, MD 21114-2472
(410) 721-5050
(301) 858-1608
Taxonomy
Speciality
Code
Description
License number
State
111NR0400X
Rehabilitation Chiropractor
Primary
S01438
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
42443403
AETNA
MD
01
—
522010294
TAX IDENTIFICATION NUMBER
MD
01
—
LX18KI
CAREFIRST MD
MD
01
—
T205001
CAREFIRST DC FEP
MD
Enumeration date
12/13/2006
Last updated
09/29/2008
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