Individual
DUSTIN KYLE UTLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
2118 E MAIN ST, HUMBOLDT, TN 38343-3054
(731) 784-1973
Mailing address
2118 E MAIN ST, HUMBOLDT, TN 38343-3054
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2886
TN
Other
Enumeration date
06/30/2009
Last updated
07/11/2013
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