| NPI | 1770909632 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DUSTIN DERIC HARLIN Optometrist 801-352-4207 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152WC0802X Optometrist, Corneal and Contact Management (Licence: UT 5948040-9934) |
| Additional Taxonomies | 152WL0500X Optometrist, Low Vision Rehabilitation (Licence: UT 5948040-9934) |
| 152WP0200X Optometrist, Pediatrics (Licence: UT 5948040-9934) | |
| Enumeration Date | 2014-03-14 |
| Last Update Date | 2021-08-03 |