Individual
RODERICK GIBBS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1505 DAPHNE AVE, DAPHNE, AL 36526-4298
(251) 625-3178
Mailing address
25273 SPINDLE LN, DAPHNE, AL 36526-5419
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
3627
AL
Other
Enumeration date
12/02/2015
Last updated
12/02/2015
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