| NPI | 1083889513 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DUSTIN DERIC HARLIN Optometrist 801-623-3723 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: UT 59480409934) |
| Enumeration Date | 2008-04-25 |
| Last Update Date | 2008-04-25 |