Organization
CENTRAL UTAH EYE ASSOCIATES
Active
Other names
Excel Eye Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DALE BLAKE (ADMINISTRATOR)
(801) 374-1818
Entity
Organization
Contact information
Practice address
1735 N STATE ST, PROVO, UT 84604-1010
(801) 374-1818
(801) 379-2959
Mailing address
1735 N STATE ST, PROVO, UT 84604-1010
(801) 374-1818
(801) 379-2959
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CB6367
RAIL ROAD MEDICARE
UT
Enumeration date
07/16/2006
Last updated
08/26/2008
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