Individual
DR. PAUL L. GUSTAFSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
543 S DAVID ST, CASPER, WY 82601-3196
(307) 237-9494
(307) 237-1370
Mailing address
543 S DAVID ST, CASPER, WY 82601-3196
(307) 237-9494
(307) 237-1370
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
267T
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
115863500
—
WY
Enumeration date
06/12/2006
Last updated
10/20/2015
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