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Organization
DOCTOR SPECS OD PC
Active
Organization
DOCTOR SPECS OD PC
Active
Other names
Pleasant Grove Eye Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRADLEY DALLAS FREESTONE O.D. (OWNER)
(801) 785-7828
Entity
Organization
Contact information
Practice address
387 S MAIN ST, PLEASANT GROVE, UT 84062-2634
(801) 785-7828
(801) 785-3384
Mailing address
387 S MAIN ST, PLEASANT GROVE, UT 84062-2634
(801) 785-7828
(801) 785-3384
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
6255330-9934
UT
152WL0500X
Low Vision Rehabilitation Optometrist
Primary
6255330-9934
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
528274468001
—
UT
Enumeration date
12/18/2006
Last updated
09/11/2025
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