Individual
MR. RANDALL W GIBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.ED., LMT
Contact information
Practice address
3250 W MARKET ST, SUITE #104, FAIRLAWN, OH 44333-3336
(330) 701-8780
Mailing address
2567 ABINGTON RD, FAIRLAWN, OH 44333-4037
(330) 701-8780
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
33-00-4126
OH
Other
Enumeration date
07/26/2006
Last updated
07/20/2012
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