| NPI | 1902195605 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL CLAYTON Administrator 801-357-7373 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: UT 1550231205) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: UT 1109409934) |
| 152W00000X Optometrist (Licence: UT 1131489934) | |
| 174400000X Specialist (Licence: UT 1709201205) | |
| 174400000X Specialist (Licence: UT 1827901205) | |
| 174400000X Specialist (Licence: UT 49624391205) | |
| 174400000X Specialist (Licence: UT 72173901205) | |
| Enumeration Date | 2011-04-04 |
| Last Update Date | 2011-09-29 |