Organization
OPTOMETRIC PHYSICIAN LLC
Active
Other names
Highland Office Sub-Part
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEVIN JAY FROMM O.D. (MANAGER)
(801) 756-9357
Entity
Organization
Contact information
Practice address
5455 W 11000 N, SUITE 101, HIGHLAND, UT 84003-8800
(801) 756-9357
(801) 756-9358
Mailing address
5455 W 11000 N, SUITE 101, HIGHLAND, UT 84003-8800
(801) 756-9357
(801) 756-9358
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
375345-9934
UT
Other
Enumeration date
05/30/2007
Last updated
08/22/2020
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