Organization
GAVIN L JOHNSON OD LLC
Active
Other names
Box Elder Vision
Organization subpart
No
Provider details
NPI number
Authorized official
GAVIN LANE JOHNSON O.D. (OWNER/OD)
(435) 730-3998
Entity
Organization
Contact information
Practice address
34 S MAIN ST, BRIGHAM CITY, UT 84302-2527
(435) 723-2485
Mailing address
34 S MAIN ST, BRIGHAM CITY, UT 84302-2527
(435) 730-3998
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Enumeration date
03/22/2023
Last updated
01/11/2024
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