NPI | 1619209673 |
---|---|
Other Name | CLASSIC OPTICAL |
Entity Type | Organization |
Authorized Contact | MICHAEL D CONKLIN Optometrist 801-261-2020 |
Organization Subpart ? | Yes |
Primary Taxonomy | 152WC0802X Optometrist, Corneal and Contact Management (Licence: UT 5354412-9934) |
Enumeration Date | 2010-02-02 |
Last Update Date | 2010-02-02 |