Individual
MERLIN LEON MCENTIRE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1200 TOWNE CENTRE BLVD SPC 2104, PROVO, UT 84601-2985
(801) 852-4405
Mailing address
1200 TOWNE CENTRE BLVD SPC 2104, PROVO, UT 84601-2985
(801) 852-4405
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
366355-9934
UT
Other
Enumeration date
12/11/2006
Last updated
07/08/2007
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