Individual
NICHOLAS GIBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1191 ELMONT RD, SULLIVAN, MO 63080-5126
(573) 205-8376
Mailing address
1191 ELMONT RD, SULLIVAN, MO 63080-5126
(573) 205-8376
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
—
—
344600000X
Taxi
Primary
—
—
Other
Enumeration date
03/11/2024
Last updated
03/11/2024
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