Organization
PROGRESSIVE EYE CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFREY L. BROADHEAD OD (MANAGING MEMBER)
(801) 676-2020
Entity
Organization
Contact information
Practice address
3556 W 9800 S, SUITE 104, SOUTH JORDAN, UT 84095-3211
(801) 676-2020
(801) 253-6591
Mailing address
3556 W 9800 S, SUITE 104, SOUTH JORDAN, UT 84095-3211
(801) 676-2020
(801) 253-6591
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4826018-9934
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
528592101002
—
UT
Enumeration date
12/19/2007
Last updated
12/21/2007
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