Healthcare Provider Details
I. General information
NPI: 1649245333
Provider Name (Legal Business Name): ESPLIN EYE CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/17/2006
Last Update Date: 04/29/2025
Certification Date: 04/29/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
59 S 400 W
SPANISH FORK UT
84660-2053
US
IV. Provider business mailing address
59 S 400 W PO BOX 267
SPANISH FORK UT
84660-1802
US
V. Phone/Fax
- Phone: 801-794-3937
- Fax: 801-794-9880
- Phone: 801-794-3937
- Fax: 801-794-9880
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 152W00000X |
| Taxonomy | Optometrist |
| License Number | 56790148908 |
| License Number State | UT |
VIII. Authorized Official
Name:
DAVID
J
ESPLIN
Title or Position: OWNER DOCTOR
Credential: OD
Phone: 801-794-3937