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Individual

SCOTT ALEXANDER GIBSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LPN

Contact information

Practice address
277 MEDICAL WAY, RIVERDALE, GA 30274-2522
(470) 298-7236
Mailing address
10019 REISTERSTOWN RD FL 3, OWINGS MILLS, MD 21117-3902

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN076640
GA

Other

Enumeration date
11/19/2021
Last updated
11/19/2021
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