Individual
DR. BRENT L HADLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1448 S STATE ST, OREM, UT 84097-7704
(801) 224-0451
(801) 224-0452
Mailing address
1448 S STATE ST, OREM, UT 84097-7704
(801) 224-0451
(801) 224-0452
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
110079-9934
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0897090001
DMERC
UT
Enumeration date
10/26/2006
Last updated
07/08/2007
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