| NPI | 1447340799 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT M ALLEN Officer 435-665-7923 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: UT 62579469934) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: UT 1138799934) |
| Enumeration Date | 2006-10-14 |
| Last Update Date | 2008-04-20 |