Organization
STANDARD OPTICAL CO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEN ACKER CPA (CFO)
(801) 886-2020
Entity
Organization
Contact information
Practice address
196 E 2000 N, SUITE 101, TOOELE, UT 84074-9335
(801) 255-5454
(801) 255-1109
Mailing address
1901 W PARKWAY BLVD, SALT LAKE CITY, UT 84119
(801) 886-2020
(801) 954-0054
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1477654846
—
UT
01
—
310188
DMBA
UT
05
—
999000797009
—
UT
Enumeration date
09/26/2006
Last updated
09/16/2009
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