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1619566833
ZACHARY GIBSON
PROVO, UT
NPI
1619566833
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: UT 10584263-1206)
Enumeration Date
2021-01-12
Last Update Date
2021-01-12
Business Address
ZACHARY GIBSON PA
1055 N 500 W BLDG A
PROVO, UT 84604-3305
Phone number: 801-354-8225
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Mailing Address
ZACHARY GIBSON PA
1055 N 500 W ATTN CREDENTIALING
PROVO, UT 84604
Phone number: 801-354-8225
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