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Organization

LEGACY VISION GROUP DBA ELEVATION EYEWORKS

Active
Parent organization
LEGACY VISION GROUP
Other names
Elevation Eyeworks
Organization subpart
Yes

Provider details

NPI number
Legal business name
LEGACY VISION GROUP
Authorized official
DR. MITCHELL ELI PEBLEY OD (OWNER)
(801) 732-8200
Entity
Organization

Contact information

Practice address
4645 MIDLAND DR STE A, WEST HAVEN, UT 84401-6824
(801) 792-8200
(801) 732-8213
Mailing address
4645 MIDLAND DR STE A, WEST HAVEN, UT 84401-6824
(801) 792-8200
(801) 732-8213

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary

Other

Enumeration date
04/28/2021
Last updated
04/28/2021
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