| |
175 W Canyon Crest Rd, Suite 305, Alpine, UT 84004-2010 | |
(801) 910-3957 | |
Not Available |
Full Name | |
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Type | Facility |
Speciality | Optometrist |
Location | 175 W Canyon Crest Rd, Alpine, Utah |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
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1205381860 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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152W00000X | Optometrist | 90422859934 (Utah) | Primary |
Mailing Address | Practice Location Address |
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175 W Canyon Crest Rd, Suite 305, Alpine, UT 84004-2010 Ph: (801) 910-3957 | 175 W Canyon Crest Rd, Suite 305, Alpine, UT 84004-2010 Ph: (801) 910-3957 |