Organization
SALT LAKE CITY EYE CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK MATTHEW MCKELL OD (OWNER)
(801) 485-9757
Entity
Organization
Contact information
Practice address
1818 S 300 W, SALT LAKE CITY, UT 84115-1805
(801) 485-9757
(801) 477-8359
Mailing address
1818 SOUTH 300 WEST, SALT LAKE CITY, UT 84115
(801) 485-9757
(801) 477-8359
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
6271198-9934
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1396853974
—
ID
Enumeration date
09/25/2017
Last updated
07/21/2022
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