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Individual

MILES J GIBSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
301 E DANNA AVE, WASILLA, AK 99654-6422
(907) 474-0890
Mailing address
PO BOX 1093, PALMER, AK 99645-1093
(907) 231-5023

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
172V00000X
Community Health Worker
Primary

Other

Enumeration date
02/13/2023
Last updated
08/13/2025
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