Individual
JONATHAN BOSTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1901 W PARKWAY BLVD, SALT LAKE CITY, UT 84119-2001
(801) 886-2020
Mailing address
1901 W PARKWAY BLVD, SALT LAKE CITY, UT 84119-2001
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
9051999-9934
UT
Other
Enumeration date
06/05/2014
Last updated
06/05/2014
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