Individual
LANETRIA A GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7275 MICHAEL ST, TAYLOR, MI 48180-1521
(131) 392-5653
Mailing address
7275 MICHAEL ST, TAYLOR, MI 48180-1521
(131) 392-5653
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
05/27/2021
Last updated
05/27/2021
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