Heather Gibson

NPI #1629431242 in Edwardsburg, Michigan

Provider Information

NPI Number: 1629431242
Entity Type: Individual
Name: Heather Gibson
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Technician, Other
Enumeration Date: Mar 31, 2016
Last Updated: Mar 31, 2016

Practice Location

Address: 71169 OLD 205
City: Edwardsburg
State: Michigan
ZIP Code: 49112-9796
Phone: (574) 304-5762

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Technician, Other	247200000X	Primary

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