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Individual

MRS. MARY G GIBBONS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LM, CPM

Contact information

Practice address
3019 W MCRAE WAY, PHOENIX, AZ 85027-4915
(623) 451-4925
(623) 451-4925
Mailing address
19238 N 21ST AVE, PHOENIX, AZ 85027-5151
(623) 451-4925

Taxonomy

Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
0161
AZ

Other

Enumeration date
07/27/2018
Last updated
07/27/2018
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