Provider Demographics
NPI:1386885937
Name:GIBBS, DESIREE (PT)
Entity type:Individual
Prefix:
First Name:DESIREE
Middle Name:
Last Name:GIBBS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 VREELAND DRIVE
Mailing Address - Street 2:BUILDING 50, SUITE 4, MONTGOMERY PROFESSIONAL CENTER
Mailing Address - City:SKILLMAN
Mailing Address - State:NJ
Mailing Address - Zip Code:08558-1404
Mailing Address - Country:US
Mailing Address - Phone:609-924-6800
Mailing Address - Fax:
Practice Address - Street 1:50 VREELAND DR
Practice Address - Street 2:BUILDING 50, SUITE 4, MONTGOMERY PROFESSIONAL CENTER
Practice Address - City:SKILLMAN
Practice Address - State:NJ
Practice Address - Zip Code:08558-2639
Practice Address - Country:US
Practice Address - Phone:609-924-6800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-11
Last Update Date:2015-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist