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1558876110
DANIEL GIBSON
PORTER, TX
NPI
1558876110
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: TX AT5012)
Enumeration Date
2017-12-05
Last Update Date
2017-12-05
Business Address
DANIEL GIBSON LAT
22539 VALLEY CANYON LN
PORTER, TX 77365-7414
Phone number: 936-327-2031
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Mailing Address
DANIEL GIBSON LAT
22539 VALLEY CANYON LN
PORTER, TX 77365-7414
Phone number: 936-327-2031
Copy
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