Individual
TRAVIS GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS
Contact information
Practice address
200 12TH STREET EXT, PRINCETON, WV 24740-2329
(304) 436-2106
Mailing address
200 12TH STREET EXT, PRINCETON, WV 24740-2329
(304) 436-2106
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
08/26/2021
Last updated
07/09/2026
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