Individual
REESE MARK LOVELESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1735 N STATE ST, PROVO, UT 84604-1010
(801) 374-1818
Mailing address
500 FOOTHILL DR, SALT LAKE CITY, UT 84148-0001
(801) 582-1565
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
11330444-9934
UT
152WC0802X
Corneal and Contact Management Optometrist
11330444-9934
UT
Other
Enumeration date
06/10/2019
Last updated
10/20/2020
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