Individual
MELISSA GIBONEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC, CSCS
Contact information
Practice address
3545 S NATIONAL AVE, SPRINGFIELD, MO 65807-7310
(417) 839-4113
Mailing address
3545 S NATIONAL AVE, SPRINGFIELD, MO 65807-7310
(417) 839-4113
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2001019984
MO
Other
Enumeration date
12/22/2014
Last updated
12/22/2014
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