Individual
ZACHARY GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
264 W 100 S, SANTAQUIN, UT 84655-8012
(385) 203-1250
(801) 812-5034
Mailing address
1055 N 500 W, ATTN CREDENTIALING, PROVO, UT 84604
(801) 354-8225
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10584263-1206
UT
Other
Enumeration date
01/12/2021
Last updated
03/25/2025
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