Individual
DR. INGER L GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
154 E GENEVA SQ, LAKE GENEVA, WI 53147-9694
(262) 249-1000
(262) 249-1255
Mailing address
154 E GENEVA SQ, LAKE GENEVA, WI 53147-9694
(262) 249-1000
(262) 249-1255
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2495
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38618100
—
WI
Enumeration date
08/29/2005
Last updated
05/15/2008
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