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Individual

LILLIAN GIBB

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT

Contact information

Practice address
1227 HWY 42, SUITE 110, PETAL, MS 39465-2790
(601) 545-2728
(601) 545-2792
Mailing address
1227 HWY 42, SUITE 110, PETAL, MS 39465-2790
(601) 545-2728
(601) 545-2792

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT3113
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
05924395
MS
Enumeration date
08/22/2005
Last updated
11/17/2011
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