Individual
KYLAN TREVOR HEATON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
910 S 300 W, BLANDING, UT 84511-3921
(435) 678-0700
Mailing address
910 S 300 W, BLANDING, UT 84511-3921
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
14299610
UT
Other
Enumeration date
08/10/2026
Last updated
08/10/2026
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