Individual
SCOTT D FARRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
640 TALON CT, N SALT LAKE, UT 84054-2631
(801) 448-4620
(801) 298-4620
Mailing address
640 TALON CT, N SALT LAKE, UT 84054-2631
(801) 448-4620
(801) 298-4620
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
109860-9933
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1306096979
—
UT
01
—
PRA03404
MOLINA
UT
Enumeration date
09/19/2008
Last updated
09/09/2010
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