Individual
MRS. MARY ELIZABETH GIBBONS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.AC., NCCAOM DIPL.
Contact information
Practice address
11250 ROGER BACON DR, SUITE 23, RESTON, VA 20190-5219
(703) 231-5058
Mailing address
6207 HARDY DR, MCLEAN, VA 22101-3115
(703) 893-1537
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
0121000334
VA
Other
Enumeration date
04/24/2007
Last updated
07/08/2007
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