Organization
SOUTH VALLEY EYECARE CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID ALLEN SMITH O.D. (PRESIDENT)
(435) 713-4444
Entity
Organization
Contact information
Practice address
276 SPRINGCREEK PKWY, PROVIDENCE, UT 84332
(435) 713-4444
(435) 787-1238
Mailing address
276 SPRINGCREEK PKWY, PROVIDENCE, UT 84332
(435) 713-4444
(435) 787-1238
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
346644-9934
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51811974400001
BLUE CROSS BLUE SHIELD
UT
05
—
518119744008
—
UT
01
—
615808
DMBA
UT
01
—
QM0000053383
ALTIUS
UT
Enumeration date
07/29/2009
Last updated
01/25/2011
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