Organization
WARREN D. GIBSON
Active
Other names
Waccamaw Prosthetics and Orthotics
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WARREN D GIBSON (PRATITIONER)
(843) 347-7281
Entity
Organization
Contact information
Practice address
1629 HIGHWAY 544, CONWAY, SC 29526-8452
(843) 347-7281
(843) 347-9785
Mailing address
1629 HIGHWAY 544, CONWAY, SC 29526-8452
(843) 347-7281
(843) 347-9785
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DE2045
—
SC
Enumeration date
08/05/2007
Last updated
06/30/2008
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