Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MARK LAWRENCE HIBBARD
Active Sole ProprietorMARK LAWRENCE HIBBARD is a Athletic Trainer healthcare provider located in JACKSON, Wyoming. NPI 1063920965 is currently active in the NPPES registry. Verify at CMS.
Athletic Trainer · JACKSON, WY
Registration Details
- NPI Number
- 1063920965
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jan 14, 2018 (8.5746927932903 yrs)
- Last Updated
- Jan 14, 2018
- Sole Proprietor
- Yes
Practice Information
- Address
-
120 W PEARL AVEJACKSON, WY, 83002Browse WY providers · Browse ZIP 83002
- Phone
- 3077349129
- Primary Specialty
-
Athletic Trainer
2255A2300X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.