Individual
CHARLONA GIBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3575 ANNA RUBY LN, DOUGLASVILLE, GA 30135-1736
(470) 388-5377
Mailing address
3575 ANNA RUBY LN, DOUGLASVILLE, GA 30135-1736
(470) 388-5377
Taxonomy
Speciality
Code
Description
License number
State
177F00000X
Lodging Provider
Primary
—
—
Other
Enumeration date
05/05/2025
Last updated
05/05/2025
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