Individual
JEFF GIBBONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
2311 PARK AVE STE 2, BURLEY, ID 83318-2170
(208) 677-2489
(208) 677-4023
Mailing address
2311 PARK AVE STE 2, BURLEY, ID 83318-2170
(208) 677-2489
(208) 677-4023
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT1623
ID
Other
Enumeration date
12/01/2006
Last updated
07/08/2007
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