Individual
JEFFREY DAVID ZILLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
495 W 600 N, TREMONTON, UT 84337
(435) 257-7436
Mailing address
495 W 600 N, TREMONTON, UT 84337-2411
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
11316580-9934
UT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/28/2019
Last updated
07/08/2019
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