| NPI | 1295057958 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHELLE NICKLE Optometrist/Owner 801-447-4393 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: UT 375826-9934) |
| Enumeration Date | 2010-02-23 |
| Last Update Date | 2011-02-22 |