NPI | 1952464331 |
---|---|
Doing Business As | PLEASANT GROVE EYE CARE CENTER |
Entity Type | Organization |
Authorized Contact | BRADLEY DALLAS FREESTONE Owner 801-785-7828 |
Organization Subpart ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: UT 6255330-9934) |
Additional Taxonomies | 152WL0500X Optometrist, Low Vision Rehabilitation (Licence: UT 6255330-9934) |
Enumeration Date | 2006-12-18 |
Last Update Date | 2020-08-22 |