Provider Demographics
NPI:1275338204
Name:MCKIBBIN, TREVOR (DPT)
Entity type:Individual
Prefix:
First Name:TREVOR
Middle Name:
Last Name:MCKIBBIN
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7521 CHERRY TREE DR
Mailing Address - Street 2:
Mailing Address - City:FULTON
Mailing Address - State:MD
Mailing Address - Zip Code:20759-9735
Mailing Address - Country:US
Mailing Address - Phone:202-794-9386
Mailing Address - Fax:
Practice Address - Street 1:1 RIGHTER PKWY STE 150
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19803-1510
Practice Address - Country:US
Practice Address - Phone:302-477-1536
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-14
Last Update Date:2025-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist