Individual
DR. JACOB LEE GIBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
8412 OLD TROY PIKE, HUBER HEIGHTS, OH 45424-1030
(937) 235-0068
Mailing address
2926 COLUMBIA TRL, LOVELAND, OH 45140-5530
(513) 703-8148
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
PT017168
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT017168
PHYSICAL THERAPY LICENSE
OH
Enumeration date
08/28/2017
Last updated
08/28/2017
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