Organization
WASATCH VIEW EYE AND LASER CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFERY L MELLOR OD (MEMBER/DOCTOR)
(801) 867-9382
Entity
Organization
Contact information
Practice address
922 BAXTER DR, 110, SOUTH JORDAN, UT 84095-8613
(801) 542-7024
Mailing address
922 BAXTER DR, 110, SOUTH JORDAN, UT 84095-8613
(801) 542-7024
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
328094-9934
UT
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Enumeration date
01/19/2010
Last updated
05/25/2010
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