| NPI | 1114100740 |
|---|---|
| Doing Business As | BARRY JACKSON OD |
| Entity Type | Organization |
| Authorized Contact | RUSSELL B JACKSON Owner Operator 435-586-1500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: UT 375344-9934) |
| Enumeration Date | 2007-12-05 |
| Last Update Date | 2008-02-11 |