Derek Busenbark Ames O.D.

NPI 1174836431 - Optometrist - 152W00000X

NPI Details
NPI 1174836431
Gender Male
Enumeration Date 07/15/2010
Last Updated 06/14/2012
Entity Type Individual
Active Over 6 years ago
Practice Location
2610 PIONEER RD
ST GEORGE UT, 84790-7442, US
Phone (435) 674-9770
Fax (435) 674-9771
Business Location
2610 PIONEER RD
ST GEORGE UT, 84790-7442, US
Phone (435) 674-9770
Fax (435) 674-9771
Toxanomy
Taxonomy Code 152W00000X
License State Utah
License Number 7693840-9934
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According to our database, Derek Busenbark Ames O.D. NPI is 1174836431, taxonomy code is 152W00000X and license number is 7693840-9934, license state is located at Utah. Derek Busenbark Ames O.D. physically located at 2610 Pioneer Rd, St George UT, 84790-7442. NPI Number Derek Busenbark Ames O.D. has the Individual type.

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1174836431 NPI number is provided on an as is basis without warranty of any kind. 1174836431 is maintained by the National Plan & Provider Enumeration System. The contents of Derek Busenbark Ames O.D. are for informational purposes only.