Individual
RICHARD DALLIN BOARDMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
810 S 100 W STE A, LOGAN, UT 84321-6093
(435) 787-7200
(435) 787-7203
Mailing address
3485 N COLE RD UNIT 45479, BOISE, ID 83711-1095
(208) 297-7019
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
ODP-100444
ID
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
07/31/2017
Last updated
07/07/2025
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