Individual
BRUCE FERRELL GIBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
345 BEVILLE RD, SUITE# 106, SOUTH DAYTONA, FL 32119-2165
(386) 760-7533
(386) 761-5868
Mailing address
345 BEVILLE RD, SUITE# 106, SOUTH DAYTONA, FL 32119-2165
(386) 760-7533
(386) 761-5868
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
FL
Other
Enumeration date
03/08/2012
Last updated
03/08/2012
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