| NPI | 1346608619 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL CONKLIN Mbr/Optometrist 801-502-7394 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: UT 5354412-9934) |
| Enumeration Date | 2016-02-02 |
| Last Update Date | 2016-02-02 |