| |
2266 N University Pkwy, Provo, UT 84604-1510 | |
(801) 373-1300 | |
Not Available |
Full Name | |
---|---|
Type | Facility |
Speciality | Eyewear Supplier |
Location | 2266 N University Pkwy, Provo, Utah |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1982656419 | NPI | - | NPPES |
014086 | Other | VIP | |
17921 | Other | MEDICARE | |
410985054-134 | Medicaid | UT | |
UT04881 | Other | UT | NORIDIAN SUBMITTER ID |
35529 | Other | AVESIS | |
42548 | Other | DAVIS | |
CP2230-47 | Other | EYEMED |
Mailing Address | Practice Location Address |
---|---|
2266 N University Pkwy, Provo, UT 84604-1510 Ph: (801) 373-1300 | 2266 N University Pkwy, Provo, UT 84604-1510 Ph: (801) 373-1300 |