| NPI | 1710919360 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIZEL DERBY President 801-599-8720 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152WC0802X Optometrist, Corneal and Contact Management (Licence: UT 372443-9934) |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2020-08-22 |