Individual
DR. MICHELE RENA AVILA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
11820 S STATE ST, SUITE 200, DRAPER, UT 84020-7133
(801) 568-0200
(801) 563-0200
Mailing address
11820 S STATE ST, SUITE 200, DRAPER, UT 84020-7133
(801) 568-0200
(801) 563-0200
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
1861
KS
152W00000X
Optometrist
2594
OK
152W00000X
Optometrist
5837
OH
152W00000X
Optometrist
Primary
9439507-9934
UT
Other
Enumeration date
07/13/2009
Last updated
11/21/2018
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