Healthcare Provider Details

I. General information

NPI: 1326461807
Provider Name (Legal Business Name): PRECISION VISION PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/04/2014
Last Update Date: 04/04/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

482 S MAIN ST
SPANISH FORK UT
84660-2410
US

IV. Provider business mailing address

482 S MAIN ST
SPANISH FORK UT
84660-2410
US

V. Phone/Fax

Practice location:
  • Phone: 801-504-6448
  • Fax: 801-504-6239
Mailing address:
  • Phone: 801-504-6448
  • Fax: 801-504-6239

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JESS E MENDENHALL
Title or Position: MEMBER
Credential: O.D.
Phone: 520-678-6567