Individual
DR. FRED LLOYD GIBSON IV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
12627 SAN JOSE BLVD STE 305, JACKSONVILLE, FL 32223-8639
(904) 683-4376
Mailing address
379 LAKE KATHRYN CIR, CASSELBERRY, FL 32707-3001
(407) 949-7037
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
12141
FL
Other
Enumeration date
11/16/2017
Last updated
09/26/2023
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