Individual
DR. EASTON CLINT KELSEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
3651 WALL AVE STE 1226, OGDEN, UT 84405-2007
(480) 732-9040
Mailing address
4907 S 1750 W, 5, ROY, UT 84067
(480) 204-9122
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
11008385-9934
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8909164
—
NC
Enumeration date
05/03/2006
Last updated
06/27/2023
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