Individual
CRAIG W VANLEEUWEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
5770 S 250 E, SUITE 410, MURRAY, UT 84107-8100
(801) 314-4420
(801) 314-4421
Mailing address
5770 S 250 E, SUITE 410, MURRAY, UT 84107-8100
(801) 352-9500
(801) 352-9502
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
111152-9934
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1427149905
—
UT
Enumeration date
09/27/2006
Last updated
10/09/2013
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