Individual
EDWIN C WINDER III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
300 S MAIN ST, TOOELE, UT 84074-2746
(435) 882-3233
Mailing address
300 S MAIN ST, TOOELE, UT 84074-2746
(435) 882-3233
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
5354338-9934
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
53543389901001
BXBS
UT
Enumeration date
08/04/2006
Last updated
07/08/2007
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