Individual
MISS CORA LEE GIBBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
SPORTS AND ORTHOPAEDIC SPECIALISTS, 8100 W 78TH STREET, SUITE 230, EDINA, MN 55439-2570
(952) 946-9777
Mailing address
SPORTS AND ORTHOPAEDIC SPECIALISTS, 8100 W. 78TH STREET, SUITE 230, EDINA, MN 55439-2570
(952) 946-9777
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Enumeration date
08/28/2016
Last updated
08/28/2016
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