| NPI | 1093297301 |
|---|---|
| Former Name | SHELBY GIBSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305212362) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WV PT004042) |
| Enumeration Date | 2018-09-04 |
| Last Update Date | 2024-07-22 |