Individual
MARIAH GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3913 GEORGETOWN RD NW, CLEVELAND, TN 37312-1806
(423) 479-3600
Mailing address
3913 GEORGETOWN RD NW, CLEVELAND, TN 37312-1806
(423) 479-3600
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
6371
TN
Other
Enumeration date
02/11/2025
Last updated
02/11/2025
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