Organization
EYE CARE FOR KIDS
Active
Other names
Eye Care 4 Kids
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOSEPH G. CARBONE ABOC, NCLC (EXECUTIVE DIRECTOR)
(801) 255-8525
Entity
Organization
Contact information
Practice address
6911 S STATE ST, MIDVALE, UT 84047-1239
(801) 255-8525
(801) 255-8526
Mailing address
6911 S STATE ST, MIDVALE, UT 84047-1239
(801) 255-8525
(801) 255-8526
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
156FC0800X
Contact Lens Technician/Technologist
—
—
156FC0801X
Contact Lens Fitter
—
—
332H00000X
Eyewear Supplier
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PRA06546
—
UT
Enumeration date
01/24/2007
Last updated
10/04/2024
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