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NPI Code Detail

MEDICARE: GIBSON CHIROPRACTIC OFFICE, PA

MEDICARE: GIBSON CHIROPRACTIC OFFICE, PA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractor

General Provider Information

NPI Number : 1104979913
Entity Type Code : Organization
Provider Name (Legal Business Name) : GIBSON CHIROPRACTIC OFFICE, PA
Provider Business Mailing Address
First Line : 9408 ARLINGTON EXPY
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32225-8231
Country : US
Telephone Number : 904-220-7575
Fax Number : 904-273-3004
Provider Business Practice Location Address
First Line : 9408 ARLINGTON EXPY
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32225-8231
Country : US
Telephone Number : 904-924-8411
Fax Number : 904-220-7510
Authorized Official
Title or Position : PRESIDENT
Name : DR. ROBERT C GIBSON
Credential : D.C.
Telephone Number : 904-220-7575
Provider Enumeration Date : 01/18/2007
Last Update Date : 08/26/2014

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Directions to “GIBSON CHIROPRACTIC OFFICE, PA ” Practice Location

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