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1023766862
ERNEST LEONARD GIBSON
DECATUR, GA
NPI
1023766862
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: GA RN207432)
Enumeration Date
2022-03-11
Last Update Date
2022-03-11
Business Address
ERNEST LEONARD GIBSON
2561 CAPTAINS ROW
DECATUR, GA 30035-3062
Phone number: 404-839-2886
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Mailing Address
ERNEST LEONARD GIBSON
2561 CAPTAINS ROW
DECATUR, GA 30035-3062
Phone number: 404-839-2886
Copy
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