Organization
GIBSON COUNTY OFFICE ON AGING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CLARICE SMITH (DIRECTOR)
(731) 742-2891
Entity
Organization
Contact information
Practice address
168 EMAIN ST, BRADFORD, TN 38316
(731) 742-2891
(731) 742-3028
Mailing address
168 EAST MAIN ST, PO BOX 190, BRADFORD, TN 38316
(731) 742-2891
(731) 742-3028
Taxonomy
Speciality
Code
Description
License number
State
251X00000X
Supports Brokerage Agency
Primary
L4380666259
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0445047
—
TN
Enumeration date
05/23/2007
Last updated
08/22/2020
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