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Individual

GINGER GIBSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
P.T.

Contact information

Practice address
118 GRACELAND BLVD STE 327, COLUMBUS, OH 43214-1530
(877) 967-5769
Mailing address
118 GRACELAND BLVD STE 327, COLUMBUS, OH 43214-1530
(312) 399-4090
(877) 967-5759

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
070016321
IL
225100000X
Physical Therapist
Primary
PT011193
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
BCBS OF IL
1619980
IL
01
CD3789
MEDICARE RAIL ROAD GROUP
IL
01
P00624021
MEDICARE RAIL ROAD
IL
Enumeration date
06/08/2006
Last updated
02/07/2020
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