Individual
DR. BALTAZAR VEGA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
560 S STATE ST STE A265, OREM, UT 84058
(801) 820-0920
Mailing address
560 S STATE ST STE A265, OREM, UT 84058-6391
(801) 820-0920
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
6779772-9934
UT
Other
Enumeration date
10/10/2012
Last updated
11/02/2019
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