Individual
KENNETH MARVIN GIBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PC
Contact information
Practice address
2231 BROAD BLVD, CUYAHOGA FALLS, OH 44223-1411
(800) 363-9886
(330) 922-9977
Mailing address
2231 BROAD BLVD, CUYAHOGA FALLS, OH 44223-1411
(800) 363-9886
(330) 922-9977
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
C4872
OH
Other
Enumeration date
07/16/2007
Last updated
07/16/2007
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