MR. Michael Gibbons, LMP

NPI #1083825905 in Bonney Lake, Washington

Provider Information

NPI Number: 1083825905
Entity Type: Individual
Name: MR. Michael Gibbons, LMP
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Massage Therapist
Credential: LMP
Enumeration Date: May 24, 2007
Last Updated: Jul 8, 2007

Practice Location

Address: 19102 STATE ROUTE 410 E STE A
City: Bonney Lake
State: Washington
ZIP Code: 98391-8449
Phone: (253) 863-6378

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Massage Therapist	225700000X	Primary

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