JAKE GIBBONS

FONTANELLE, IA
NPI1043488562
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy224Z00000X Occupational Therapy Assistant
(Licence: IA  00306)
Enumeration Date2008-02-19
Last Update Date2008-02-19
Business Address
-- JAKE GIBBONS OTA
326 SUMMERSET ST
FONTANELLE, IA 50846-8098
Phone number: 615-896-6400
Mailing Address
-- JAKE GIBBONS OTA
624 W NORTH ST
MADRID, IA 50156-1024
Phone number: 615-896-6400