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1740041748
OPTVIDA, LLC
LOGAN, UT
NPI
1740041748
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Entity Type
Organization
Authorized Contact
CANDACE ANN JAMES
Owner
435-553-5915
Organization Subpart ?
No
Primary Taxonomy
363LP0808X Nurse Practitioner, Psych/Mental Health
Enumeration Date
2024-01-17
Last Update Date
2024-01-17
Business Address
OPTVIDA, LLC
1034 RSI DR UNIT 120
LOGAN, UT 84321-2203
Phone number: 435-704-9342
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Mailing Address
OPTVIDA, LLC
98 E 500 S
PROVIDENCE, UT 84332-9801
Phone number: 435-553-5915
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