| NPI | 1922282599 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY L. BROADHEAD Managing Member 801-676-2020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: UT 4826018-9934) |
| Enumeration Date | 2007-12-19 |
| Last Update Date | 2007-12-21 |