Individual
MS. RENEE L GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSPT
Contact information
Practice address
336 FAIRGROUNDS RD, HAMILTON, MT 59840-3126
(406) 375-9034
(406) 375-9938
Mailing address
2207 WYLIE AVE, MISSOULA, MT 59802-3533
(406) 544-9344
(406) 375-9938
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1909
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1639390495
—
MT
Enumeration date
05/01/2007
Last updated
08/17/2016
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