Provider Demographics
NPI:1639876832
Name:GIBSON, KATELYN HOPE (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:
First Name:KATELYN
Middle Name:HOPE
Last Name:GIBSON
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2307 W ANDREW JOHNSON HWY STE 110
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:37814-3298
Mailing Address - Country:US
Mailing Address - Phone:423-616-1084
Mailing Address - Fax:
Practice Address - Street 1:2307 W ANDREW JOHNSON HWY
Practice Address - Street 2:SUITE 110
Practice Address - City:MORRISTOWN
Practice Address - State:TN
Practice Address - Zip Code:37814-3298
Practice Address - Country:US
Practice Address - Phone:423-616-1084
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-08
Last Update Date:2023-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist