Individual
MARTHA FAY GIBSON
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
DPH
Contact information
Practice address
SYNDY & LAMONT ST, JOHNSON CITY, TN 37601
(423) 926-1171
Mailing address
787 WOODMONT RD, JONESBOROUGH, TN 37659-3765
(423) 753-9186
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
4660
TN
Other
Enumeration date
02/16/2006
Last updated
07/08/2007
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