| NPI | 1881801504 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYNELLE HANSEN Administrator 435-637-8689 |
| Organization Subpart ? | No |
| Primary Taxonomy | 156FX1100X Technician/Technologist, Ophthalmic (Licence: UT 289301-1205) |
| Additional Taxonomies | 174400000X Specialist (Licence: UT 289301-1205) |
| Enumeration Date | 2007-05-16 |
| Last Update Date | 2010-01-05 |