Individual
ANTWONIA GIBBONS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
408 MILL ST, LOUISVILLE, GA 30434-1718
(404) 809-5708
Mailing address
PO BOX 742, LOUISVILLE, GA 30434-0742
(404) 809-5708
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
GA
Other
Enumeration date
07/31/2021
Last updated
08/01/2021
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