Organization
LOOSEN UP BODYWORK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GINA D TIBBS CMT (OWNER)
(925) 289-9750
Entity
Organization
Contact information
Practice address
1407 OAKLAND BLVD STE 100, WALNUT CREEK, CA 94596-4300
(925) 289-9750
Mailing address
1407 OAKLAND BLVD STE 100, WALNUT CREEK, CA 94596-4300
(925) 289-9750
Taxonomy
Speciality
Code
Description
License number
State
204C00000X
Sports Medicine (Neuromusculoskeletal Medicine) Physician
Primary
—
—
Other
Enumeration date
07/05/2023
Last updated
07/05/2023
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