Individual
MELISSA GIBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5963 HANNAN TRACE RD, GLENWOOD, WV 25520-9080
(304) 593-4922
Mailing address
5963 HANNAN TRACE RD, GLENWOOD, WV 25520-9080
(304) 593-4922
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
04/13/2021
Last updated
04/13/2021
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