Organization
BOSTER VISION, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN BOSTER O.D. (MANAGER)
(801) 404-2825
Entity
Organization
Contact information
Practice address
4848 S 900 W, RIVERDALE, UT 84405-3726
(801) 404-2825
Mailing address
2133 W 900 N, FARR WEST, UT 84404-9586
(801) 404-2825
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
9051999-9934
UT
Other
Enumeration date
06/27/2017
Last updated
06/27/2017
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