Provider Demographics
NPI:1629031158
Name:GIBBS, JOLENE MARIE (PT, MS)
Entity type:Individual
Prefix:MRS
First Name:JOLENE
Middle Name:MARIE
Last Name:GIBBS
Suffix:
Gender:F
Credentials:PT, MS
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Mailing Address - Street 1:175 COMMONS LOOP
Mailing Address - Street 2:SUITE 100
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59901-1904
Mailing Address - Country:US
Mailing Address - Phone:406-270-7262
Mailing Address - Fax:
Practice Address - Street 1:175 COMMONS LOOP
Practice Address - Street 2:SUITE 100
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-1904
Practice Address - Country:US
Practice Address - Phone:406-752-7250
Practice Address - Fax:406-752-6250
Is Sole Proprietor?:No
Enumeration Date:2006-04-07
Last Update Date:2016-06-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MT1604225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist