| NPI | 1356516801 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT E. BALDWIN Owner 435-752-6110 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: UT 112533-9934) |
| Additional Taxonomies | 332H00000X Eyewear Supplier (Licence: UT 08-00959) |
| Enumeration Date | 2008-04-25 |
| Last Update Date | 2008-11-18 |