Individual
ROGER F YOUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
3465 PIONEER PKWY STE 5, WEST VALLEY CITY, UT 84120-2079
(801) 966-0081
(801) 966-0218
Mailing address
3465 PIONEER PKWY STE 5, WEST VALLEY CITY, UT 84120-2081
(801) 966-0081
(801) 966-0218
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4780952-9934
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
47809529900001
BLUE CROSS BLUE SHIELD
—
Enumeration date
08/31/2006
Last updated
06/30/2010
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