KEVIN MARK ELLSWORTH

LOGAN, UT
NPI1669457024
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy152W00000X Optometrist
(Licence: UT  112376-9934)
Enumeration Date2005-12-08
Last Update Date2008-08-20
Business Address
Dr. KEVIN MARK ELLSWORTH O.D.
395 E 1400 N SUITE B
LOGAN, UT 84341-7573
Phone number: 435-752-5585
Mailing Address
Dr. KEVIN MARK ELLSWORTH O.D.
395 E 1400 N SUITE B
LOGAN, UT 84341-7573
Phone number: 435-752-5585
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