Individual
ANGELA FARA GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
157 11TH ST, RUPERT, WV 25984
(304) 667-0913
Mailing address
PO BOX 1151, RUPERT, WV 25984-1151
(304) 667-0913
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
10/15/2020
Last updated
01/10/2023
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