Organization
EASTERN UTAH EYE PHYSICIANS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LYNELLE HANSEN (ADMINISTRATOR)
(435) 637-8689
Entity
Organization
Contact information
Practice address
200 N FAIRGROUNDS RD, SUITE 2, PRICE, UT 84501-4205
(435) 637-8689
(435) 637-1123
Mailing address
200 N FAIRGROUNDS RD, SUITE 2, PRICE, UT 84501-4205
(435) 637-8689
(435) 637-1123
Taxonomy
Speciality
Code
Description
License number
State
156FX1100X
Ophthalmic Technician/Technologist
Primary
289301-1205
UT
174400000X
Specialist
289301-1205
UT
Other
Enumeration date
05/16/2007
Last updated
01/05/2010
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