MARK GIBSON

TALLAHASSEE, FL
NPI1619391802
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy224P00000X Prosthetist
(Licence: FL  POR276)
Additional Taxonomies222Z00000X 
(Licence: FL  POR276)
Enumeration Date2014-02-10
Last Update Date2014-11-13
Business Address
-- MARK GIBSON CPO
3334 CAPITAL MEDICAL BLVD #400
TALLAHASSEE, FL 32308-4470
Phone number: 850-877-8174
Mailing Address
-- MARK GIBSON CPO
3334 CAPITAL MEDICAL BLVD #400
TALLAHASSEE, FL 32308-4470
Phone number: 850-877-8174
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