Retinapro, Pc

NPI 1104061167 - Ophthalmology - 207W00000X

NPI Details
NPI 1104061167
Enumeration Date 12/04/2008
Last Updated 01/08/2009
Entity Type Healthcare Provider
Active Over 8 years ago
Authorized Information
Name JEANNE JEANNE
Position OFFICE ADMINISTRATOR
Phone (801) 408-3705
Fax (801) 408-3706
Practice Location
440 D ST
210
SALT LAKE CITY UT, 84103-2817, US
Phone (801) 408-3705
Fax (801) 408-3706
Business Location
440 D ST
210
SALT LAKE CITY UT, 84103-2817, US
Phone (801) 408-3705
Fax (801) 408-3706
Toxanomy
Taxonomy Code 207W00000X
License State Utah
License Number 5216808-1205
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According to our database, Retinapro, Pc NPI is 1104061167, taxonomy code is 207W00000X and license number is 5216808-1205, license state is located at Utah. Retinapro, Pc physically located at 440 D St, Salt Lake City UT, 84103-2817. NPI Number 1033115704 has the healthcare provider type.

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1104061167 NPI number is provided on an as is basis without warranty of any kind. 1104061167 is maintained by the National Plan & Provider Enumeration System. The contents of Retinapro, Pc are for informational purposes only.