| NPI | 1609129386 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN R BROCKBANK Managing Member 801-803-2470 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: UT 56014859934) |
| Enumeration Date | 2012-10-18 |
| Last Update Date | 2013-06-04 |