Individual
LILI D GIPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
715A BASCOMB COMMERCIAL PKWY, WOODSTOCK, GA 30189-2466
(770) 924-9400
Mailing address
PO BOX 2363, ACWORTH, GA 30102-0007
(770) 924-9400
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
3030
GA
111NN1001X
Nutrition Chiropractor
3030
GA
111NS0005X
Sports Physician Chiropractor
Primary
3030
GA
Other
Enumeration date
09/26/2006
Last updated
10/20/2015
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