Most Relevant Information
Provider Data
| NPI Number: | 1003423013 |
| Provider Name: | CHARLES KEITH GIBSON |
| Entity Type: | Individual |
| Taxonomy Code: | 253Z00000X |
| Specialty: | In Home Supportive Care |
| License Number: |
Most Important Dates
| Enumeration Date: | 09/24/2020 |
| Last Updated: | 09/24/2020 |
Provider Practice Location
4110 ANN ELISE CT
FAIRFIELD TOWNSHIP
OH
450116211
Practice Location Phone/Fax
| Phone: | 5139071843 |
| Fax: |
Provider Mailing Location
4110 ANN ELISE CT
FAIRFIELD TOWNSHIP
OH
450116211
Provider Mailing Phone/Fax
| Phone: | 5139071843 |
| Fax: |