Individual
MRS. AUGUSTINA DORA GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5155 SCOFIELD RD, ATLANTA, GA 30349-3301
(470) 326-0286
(404) 559-8804
Mailing address
5155 SCOFIELD RD, ATLANTA, GA 30349-3301
(470) 326-0286
(404) 559-8804
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
GA
Other
Enumeration date
02/06/2019
Last updated
08/03/2022
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