Individual
MR. SHANNON B GIBBS JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS, ATC, LAT
Contact information
Practice address
815 OLD WEST POINT RD, STARKVILLE, MS 39759-7712
(601) 678-9793
Mailing address
815 OLD WEST POINT RD, STARKVILLE, MS 39759-7712
(601) 678-9793
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0939
MS
Other
Enumeration date
01/18/2024
Last updated
01/18/2024
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