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Organization
MICHAEL GIBSON
Active
Organization
MICHAEL GIBSON
Active
Other names
Specialty Transportation
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE TURNER (MANAGER)
(423) 300-2110
Entity
Organization
Contact information
Practice address
194 JONES RD, SNEEDVILLE, TN 37869-3639
(423) 300-2110
Mailing address
PO BOX 202, SNEEDVILLE, TN 37869-0202
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q018573
—
TN
Enumeration date
07/05/2018
Last updated
07/05/2018
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