Provider Demographics
NPI:1730460031
Name:GIBBS, JENNA TAYLOR (DC)
Entity Type:Individual
Prefix:DR
First Name:JENNA
Middle Name:TAYLOR
Last Name:GIBBS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5051 STRAFFORD OAKS DR
Mailing Address - Street 2:
Mailing Address - City:SEBRING
Mailing Address - State:FL
Mailing Address - Zip Code:33875-4763
Mailing Address - Country:US
Mailing Address - Phone:863-381-7029
Mailing Address - Fax:
Practice Address - Street 1:527 US HIGHWAY 27 S
Practice Address - Street 2:
Practice Address - City:SEBRING
Practice Address - State:FL
Practice Address - Zip Code:33870-2108
Practice Address - Country:US
Practice Address - Phone:863-273-8747
Practice Address - Fax:863-658-1328
Is Sole Proprietor?:No
Enumeration Date:2011-08-31
Last Update Date:2024-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 10400111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor