| NPI | 1548483019 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAUNNA M PAXMAN Billing Manager 801-756-7996 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: UT 152W00000X) |
| Enumeration Date | 2007-04-11 |
| Last Update Date | 2019-12-13 |