Organization
STANDARD OPTICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH A ACKER CFO (CFO)
(801) 886-2020
Entity
Organization
Contact information
Practice address
1656 WEST 9000 SOUTH, WEST JORDAN, UT 84088
(801) 255-5454
(801) 255-1109
Mailing address
1901 WEST PARKWAY BLVD, SALT LAKE CITY, UT 84119
(801) 886-2020
(801) 934-0054
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
56820809934
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
999000797009
—
UT
Enumeration date
08/05/2008
Last updated
08/05/2008
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