Individual
OLANDA GIBBS THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PP
Contact information
Practice address
133 HILLSIDE LN, FITZGERALD, GA 31750-8807
(229) 425-6157
Mailing address
133 HILLSIDE LN, FITZGERALD, GA 31750-8807
(229) 425-6157
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
054862223
GA
Other
Enumeration date
04/11/2019
Last updated
04/11/2019
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