Individual
DAYTON GIBBS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4500 PECOS ST, FORT WORTH, TX 76119-5166
(817) 420-3244
Mailing address
9016 PENNY LN, FORT WORTH, TX 76123-3562
(817) 420-3244
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
02/07/2020
Last updated
02/07/2020
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