| NPI | 1659917706 |
|---|---|
| Doing Business As | CLASSIC OPTICAL |
| Entity Type | Organization |
| Authorized Contact | JEFFREY L BROADHEAD Managing Member 801-676-2020 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist |
| Additional Taxonomies | 152WC0802X Optometrist, Corneal and Contact Management |
| Enumeration Date | 2019-11-25 |
| Last Update Date | 2019-11-25 |