| NPI | 1952840829 |
|---|---|
| Doing Business As | PARK CITY VISION SOURCE |
| Entity Type | Organization |
| Authorized Contact | STEPHANIE A CASTLE Optometrist/Owner 435-649-5200 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: UT 7960144-9934) |
| Enumeration Date | 2017-02-13 |
| Last Update Date | 2017-02-27 |