Individual
MAVERIK NICHOLAS SHUMWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
910 S 300 W, BLANDING, UT 84511-3921
(435) 678-0590
Mailing address
2801 N BLUE MOUNTAIN RD, BLANDING, UT 84511-2012
(435) 459-1923
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
13396974-8908
UT
Other
Enumeration date
04/03/2023
Last updated
05/16/2023
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