Organization
EYE DOCTOR LLC
Active
Other names
Promontory Family Vision
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEREMIAH V CHURCH OD (OPTOMETRIST)
(801) 479-7850
Entity
Organization
Contact information
Practice address
5331 ADAMS AVE PKWY STE B, OGDEN, UT 84405-4755
(801) 479-7850
(801) 479-7825
Mailing address
11187 S 2865 W, SOUTH JORDAN, UT 84095-8438
(801) 910-6063
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
152WL0500X
Low Vision Rehabilitation Optometrist
—
—
Other
Enumeration date
05/29/2020
Last updated
05/29/2020
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