Individual
SHAWN GIBBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
155 N 400 W, B6, OREM, UT 84057-1909
(801) 224-1300
(801) 225-3236
Mailing address
162 N 400 W, LINDON, UT 84042-1818
(801) 836-7650
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
8154463-1206
UT
Other
Enumeration date
12/01/2011
Last updated
12/01/2011
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