| NPI | 1245354901 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | CATHY TESAR Director Of Insurance 435-789-1552  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 152W00000X Optometrist (Licence: UT 1137489934)  | 
| Additional Taxonomies | 152W00000X Optometrist (Licence: UT 1145979934)  | 
| Enumeration Date | 2007-03-19 | 
| Last Update Date | 2008-06-03 |