| NPI | 1548094246 | 
|---|---|
| Doing Business As | BLACK ROCK EYE CARE | 
| Entity Type | Organization | 
| Authorized Contact | DALLIN WILSON Optometrist 435-359-1444 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 152W00000X Optometrist | 
| Enumeration Date | 2024-08-27 | 
| Last Update Date | 2024-08-27 |