Organization
LIFE VISION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MITCH PEBLEY OD (OWNER)
(801) 513-8933
Entity
Organization
Contact information
Practice address
FREEPORT CENTER, BUILDING D-11, CLEARFIELD, UT 84016
(801) 513-8933
Mailing address
4138 S 3475 W, WEST HAVEN, UT 84401-8457
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Enumeration date
03/22/2022
Last updated
03/22/2022
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