| |
4850 W 3500 S, West Valley City, UT 84120-2927 | |
(801) 967-6300 | |
Not Available |
Full Name | |
---|---|
Type | Facility |
Speciality | Eyewear Supplier |
Location | 4850 W 3500 S, West Valley City, Utah |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1588617351 | NPI | - | NPPES |
42579 | Other | DAVIS | |
UT04872 | Other | UT | NORIDIAN SUBMITTER ID |
014097 | Other | VIP | |
041098505-006 | Medicaid | UT | |
17926 | Other | MEDICARE | |
CP2230-55 | Other | EYEMED |
Mailing Address | Practice Location Address |
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4850 W 3500 S, West Valley City, UT 84120-2927 Ph: (801) 967-6300 | 4850 W 3500 S, West Valley City, UT 84120-2927 Ph: (801) 967-6300 |