Individual
ELISA L GIBBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
419 N PARK ST, MULLINS, SC 29574-2226
(843) 246-3328
Mailing address
419 N PARK ST, MULLINS, SC 29574-2226
(843) 246-3328
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
IHCP-0924
SC
Other
Enumeration date
05/26/2019
Last updated
05/26/2019
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