| NPI | 1174160170 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNA O'BRIEN Owner 435-429-1686 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152WP0200X Optometrist Pediatrics |
| Additional Taxonomies | 152W00000X Optometrist |
| 152WS0006X Optometrist Sports Vision | |
| 152WV0400X Optometrist Vision Therapy | |
| Enumeration Date | 2019-12-09 |
| Last Update Date | 2019-12-09 |