Individual
AUGUSTINA MARIE GIBBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
300 N SYLVAN DR, GREENVILLE, NC 27834-5136
(252) 917-9072
Mailing address
300 N SYLVAN DR, GREENVILLE, NC 27834-5136
(252) 917-9072
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
25924228
NC
Other
Enumeration date
03/13/2019
Last updated
03/13/2019
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