Provider Demographics
NPI:1285866871
Name:GIBB, JOY (ABOC)
Entity Type:Individual
Prefix:
First Name:JOY
Middle Name:
Last Name:GIBB
Suffix:
Gender:F
Credentials:ABOC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1608 S 1220 W
Mailing Address - Street 2:
Mailing Address - City:WOODS CROSS
Mailing Address - State:UT
Mailing Address - Zip Code:84087-2373
Mailing Address - Country:US
Mailing Address - Phone:801-450-6731
Mailing Address - Fax:
Practice Address - Street 1:1608 S 1220 W
Practice Address - Street 2:
Practice Address - City:WOODS CROSS
Practice Address - State:UT
Practice Address - Zip Code:84087-2373
Practice Address - Country:US
Practice Address - Phone:801-450-6731
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-14
Last Update Date:2009-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician