| NPI | 1699478545 |
|---|---|
| Doing Business As | BOX ELDER VISION |
| Entity Type | Organization |
| Authorized Contact | GAVIN LANE JOHNSON Owner/Od 435-730-3998 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Enumeration Date | 2023-03-22 |
| Last Update Date | 2024-01-11 |