Organization
EYECARE WELLNESS CLINIC P.L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID BOYLE BURNETT O.D. (PRESIDENT)
(801) 309-4832
Entity
Organization
Contact information
Practice address
4848 S 900 W, RIVERDALE, UT 84405-3726
(801) 627-9868
(801) 627-9870
Mailing address
174 OAKRIDGE DR, FARMINGTON, UT 84025-3625
(801) 627-9868
(801) 627-9870
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
5676092-9934
UT
Other
Enumeration date
05/12/2010
Last updated
05/12/2010
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