NPI 1063920965

Mark Lawrence Hibbard

Practitioner Athletic Trainer Jackson, WY

Practice location

Address: 120 W Pearl Ave, Jackson, WY 83002
Phone: (307) 734-9129
Mailing address: PO Box 7791, Jackson, WY 83002-7791

Registered specialties

Athletic Trainer Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 2255A2300X

Other Specialist/Technologist providers in Wyoming →

Registry record

NPI: 1063920965
Entity type: Individual
Sex (as registered): Male
NPI issued: 14 Jan 2018
Record last updated: 14 Jan 2018

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.