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Individual

DONNIE GIBSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
405 SANDERS DR, ROCKY MOUNT, NC 27801-7839
(252) 813-4475
Mailing address
405 SANDERS DR, ROCKY MOUNT, NC 27801-7839
(252) 813-4475

Taxonomy

Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
24613112
NC

Other

Enumeration date
02/22/2022
Last updated
02/22/2022
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