Individual
SARA GRACE GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
19320 E ADMIRAL PL STE B, CATOOSA, OK 74015-3240
(918) 340-5503
Mailing address
4318 S TRENTON AVE, TULSA, OK 74105-4130
(539) 525-1889
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
10/07/2020
Last updated
10/07/2020
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