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1447753140
ADAM GIBSON
FORT WAYNE, IN
NPI
1447753140
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: IN 36002944A)
Enumeration Date
2018-03-09
Last Update Date
2018-03-09
Business Address
ADAM GIBSON ATC
3946 ICE WAY
FORT WAYNE, IN 46805-1018
Phone number: 765-206-1042
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Mailing Address
ADAM GIBSON ATC
8500 S 100 W
FAIRMOUNT, IN 46928-9228
Phone number: 765-206-1042
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