Organization
SLC WALMART EYE DOCS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL CONKLIN OD (MBR/OPTOMETRIST)
(801) 502-7394
Entity
Organization
Contact information
Practice address
3590 W SOUTH JORDAN PKWY, SOUTH JORDAN, UT 84095-8916
(801) 601-3131
Mailing address
9067 S BORDEAUX WAY, SANDY, UT 84093-2216
(801) 502-7394
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
5354412-9934
UT
Other
Enumeration date
02/02/2016
Last updated
02/02/2016
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