Individual
SAMANTHA GIBBONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1604 DODFORD CT, WAKE FOREST, NC 27587-4692
(919) 745-0009
Mailing address
1604 DODFORD CT, WAKE FOREST, NC 27587-4692
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
02/11/2019
Last updated
02/11/2019
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