Individual
MRS. ROBERTA GIBBONS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1479 W BOUNDARY ST, LOUISVILLE, GA 30434-3812
(478) 206-7731
Mailing address
1479 W BOUNDARY ST, LOUISVILLE, GA 30434-3812
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
—
Other
Enumeration date
06/01/2026
Last updated
06/01/2026
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