| NPI | 1679166193 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BENJAMIN GARRISON Managing Partner 801-564-4436 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Additional Taxonomies | 152WC0802X Optometrist Corneal and Contact Management |
| 152WP0200X Optometrist Pediatrics | |
| 152WS0006X Optometrist Sports Vision | |
| 152WV0400X Optometrist Vision Therapy | |
| 152WX0102X Optometrist Occupational Vision | |
| 156F00000X Technician/Technologist | |
| 156FC0800X Technician/Technologist Contact Lens | |
| 156FC0801X Technician/Technologist Contact Lens Fitter | |
| 156FX1100X Technician/Technologist Ophthalmic | |
| 156FX1101X Technician/Technologist Ophthalmic Assistant | |
| 156FX1201X Technician/Technologist Optometric Assistant | |
| 156FX1202X Technician/Technologist Optometric Technician | |
| 156FX1700X Technician/Technologist Ocularist | |
| Enumeration Date | 2021-02-16 |
| Last Update Date | 2021-02-22 |