Individual
WARREN DOUGLAS GIBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
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
02/13/2006
Last updated
11/08/2007
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