Individual
BETHANY RUTH GILLETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
3029 S COLT PLAZA DR STE 1, WEST VALLEY CITY, UT 84128-4015
(801) 968-6772
(801) 968-6771
Mailing address
3029 S COLT PLAZA DR STE 1, WEST VALLEY CITY, UT 84128-4015
(801) 968-6772
(801) 968-6771
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
117805229934
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1174708663
MOUNTAIN WEST EYECARE, LLC
UT
Enumeration date
05/27/2020
Last updated
05/27/2020
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