Individual
CANDIS GIBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
967 PAOLI PIKE, WEST CHESTER, PA 19380-4527
(302) 709-1919
Mailing address
77 CHAMBORD DR, NEWARK, DE 19702-5550
(646) 474-2138
Taxonomy
Speciality
Code
Description
License number
State
224P00000X
Prosthetist
Primary
CO301793
PA
224P00000X
Prosthetist
M1-0101543
DE
Other
Enumeration date
01/17/2018
Last updated
08/27/2019
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