Individual
DR. GUSTAF ISAAC GIBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
145 W CACHE VALLEY BLVD, LOGAN, UT 84341-8473
(435) 787-9273
(435) 787-9275
Mailing address
435 W 1140 N, LOGAN, UT 84341-6994
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
2994T
OR
152W00000X
Optometrist
Primary
5823517-9934
UT
Other
Enumeration date
01/17/2006
Last updated
06/15/2023
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