Organization
MT OGDEN EYE CENTER LLC
Active
Other names
UTAH EYE CENTERS
Organization subpart
No
Provider details
NPI number
Authorized official
SARAH HOWELL (CREDENTIALING MANAGER)
(801) 409-9900
Entity
Organization
Contact information
Practice address
1551 RENAISSANCE TOWNE DR, SUITE 340, BOUNTIFUL, UT 84010-7667
(801) 409-9900
(801) 409-9901
Mailing address
PO BOX 30015, DEPT 93, SALT LAKE CITY, UT 84130-0015
(801) 409-9900
(801) 409-9901
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
176195-1205
UT
332H00000X
Eyewear Supplier
2012-42863
UT
Other
Enumeration date
10/01/2008
Last updated
04/10/2013
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