Individual
COLLEEN E GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1479 3RD ST, BRILLIANT, OH 43913-1000
(740) 598-2054
Mailing address
1479 3RD ST, BRILLIANT, OH 43913-1000
(740) 598-2054
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
113761
OH
Other
Enumeration date
05/16/2021
Last updated
05/16/2021
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