Individual
DR. MITCHELL ELI PEBLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1438 E MAIN ST, #4, LEHI, UT 84043-3814
(801) 753-7999
(801) 753-7996
Mailing address
1901 PARKWAY BLVD, SALT LAKE CITY, UT 84119-2001
(801) 886-2020
(801) 954-0054
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
7378183-9934
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1023242435
—
UT
Enumeration date
06/23/2009
Last updated
05/05/2010
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