Organization
STANDARD OPTICAL CO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEN ACKER CPA (CFO)
(801) 886-2020
Entity
Organization
Contact information
Practice address
1200 PROVO TOWNE CENTRE, 1060, PROVO, UT 84601
(801) 373-2254
(801) 852-5014
Mailing address
1901 W PARKWAY BLVD, SALT LAKE CITY, UT 84119
(801) 886-2020
(801) 954-0054
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1891882155
—
UT
05
—
999000797009
—
UT
Enumeration date
10/06/2006
Last updated
09/15/2009
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