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1215654900
COREY DWAYNE GIBBS
CONYERS, GA
NPI
1215654900
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
261QA0600X Clinic/Center, Adult Day Care
Enumeration Date
2022-10-24
Last Update Date
2022-10-24
Business Address
COREY DWAYNE GIBBS
1040 PLANTATION BLVD SE
CONYERS, GA 30094-4119
Phone number: 404-717-7631
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Mailing Address
COREY DWAYNE GIBBS
1040 PLANTATION BLVD SE
CONYERS, GA 30094-4119
Phone number: 404-717-7631
Copy
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