Individual
DEREK BUSENBARK AMES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
2610 PIONEER RD, ST GEORGE, UT 84790-7442
(435) 674-9770
(435) 674-9771
Mailing address
2610 PIONEER RD, ST GEORGE, UT 84790-7442
(435) 674-9770
(435) 674-9771
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
7693840-9934
UT
Other
Enumeration date
07/15/2010
Last updated
06/14/2012
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