Individual
LATOYA GIBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1235 SECOND NORTH ST, VICKSBURG, MS 39183-3041
(769) 203-1025
Mailing address
1235 SECOND NORTH STREET, VICKSBURG, MS 39183
(769) 203-1025
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Enumeration date
05/15/2014
Last updated
05/15/2014
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