DEDERRICK GIBSON

BENTON, AR
NPI1225343916
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy171M00000X Case Manager/Care Coordinator
Enumeration Date2010-08-18
Last Update Date2010-08-18
Business Address
-- DEDERRICK GIBSON Recovery Assistant
6701 HIGHWAY 67 BLDG 4
BENTON, AR 72015-8909
Phone number: 501-315-3344
Mailing Address
-- DEDERRICK GIBSON Recovery Assistant
PO BOX 1589
BENTON, AR 72018-1589
Phone number: 501-315-3344
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