Individual
MR. DOUGLAS KEVIN HIBBS
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
364 RIVERVIEW AVE, LOGAN, WV 25601-3428
(304) 752-4443
(304) 752-8802
Mailing address
364 RIVERVIEW AVE, LOGAN, WV 25601-3428
(304) 752-4443
(304) 752-8802
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
868
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0156387000
—
WV
Enumeration date
06/16/2006
Last updated
07/08/2007
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