Individual
LINDA I GIBBENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC, LAT
Contact information
Practice address
2112 CLEVELAND BLVD, CALDWELL, ID 83605-4432
(208) 459-5873
(208) 459-5854
Mailing address
902 LINFIELD PL, CALDWELL, ID 83605-5197
(208) 454-8001
(208) 454-8001
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2255A2300X
ID
Other
Enumeration date
02/28/2007
Last updated
07/08/2007
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