Organization
CEDAR OPTHALMIC ASSOCIATES PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. RACHELLE GRONNING (OFFICE MANAGER)
(435) 586-1131
Entity
Organization
Contact information
Practice address
1811 W ROYAL HUNTE DR STE 1, CEDAR CITY, UT 84720-8174
(435) 586-1131
(435) 865-1121
Mailing address
1811 W ROYAL HUNTE DR STE 1, CEDAR CITY, UT 84720-8174
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
519861128011
—
UT
05
—
52804678808
—
UT
Enumeration date
10/24/2017
Last updated
06/16/2018
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