Individual
MRS. JENNIFER ANN GIBBARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MOTR/L
Contact information
Practice address
510 E 17TH ST # 400, IDAHO FALLS, ID 83404-6154
(208) 589-4365
Mailing address
4573 TRANQUIL PL, AMMON, ID 83406-5005
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT-785
ID
Other
Enumeration date
09/04/2006
Last updated
07/08/2007
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