Individual
MATTHEW MACKINNON GIBBS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
211 VILLAGE DR, ST SIMONS IS, GA 31522
(912) 580-9811
Mailing address
211 VILLAGE DR, ST SIMONS IS, GA 31522
(912) 580-9811
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
09/02/2018
Last updated
09/02/2018
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