Organization
BRADLEY V FELLOWS INC
Active
Other names
Vision Care Centers
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRADLEY V FELLOWS OD (OWNER PRESIDENT)
(801) 566-4119
Entity
Organization
Contact information
Practice address
9035 SOUTH 1300 EAST, 100, SANDY, UT 84094
(801) 619-9494
(801) 619-9546
Mailing address
9035 SOUTH 1300 EAST, SUITE 100, SANDY, UT 84094
(801) 566-4119
(801) 568-3844
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1135088908
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
524900806001
—
UT
Enumeration date
11/06/2006
Last updated
08/22/2020
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