Individual
SONJA RENEE GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MT
Contact information
Practice address
275 GLYNN ST S, FAYETTEVILLE, GA 30214-2015
(470) 278-5175
Mailing address
275 GLYNN ST S, FAYETTEVILLE, GA 30214-2015
(470) 278-5175
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
00008687
GA
Other
Enumeration date
08/21/2020
Last updated
08/21/2020
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