Organization
MNA GIBSON P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK WILLIAM GIBSON D.C. (PRESIDENT)
(208) 896-5520
Entity
Organization
Contact information
Practice address
7A REICH ST., MARSING, ID 83639
(208) 896-5520
(208) 896-9920
Mailing address
3536 E TALLOW LN, BOISE, ID 83716-7092
(208) 921-1781
(208) 896-9920
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIA-1130
ID
Other
Enumeration date
03/10/2008
Last updated
03/10/2008
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