Individual
TARA TRACI GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
100 WAYMONT CT STE 120, LAKE MARY, FL 32746-3412
(502) 759-2444
Mailing address
100 WAYMONT CT STE 120, LAKE MARY, FL 32746-3412
(502) 759-2444
Taxonomy
Speciality
Code
Description
License number
State
2251N0400X
Neurology Physical Therapist
Primary
PT38351
FL
Other
Enumeration date
12/21/2017
Last updated
02/09/2024
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