| NPI | 1477762805 |
|---|---|
| Other Name | PLEASANT GROVE OFFICE SUB-PART |
| Entity Type | Organization |
| Authorized Contact | KEVIN JAY FROMM Manager 801-796-1054 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: UT 375345-9934) |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2020-08-22 |