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General NPI Number Information
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NPI Number | 1356537401
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Entity Type | Organization
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Legal Business Name | EAGLE EYE CARE, INC.
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Dates
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Enumeration Date | 09/22/2007
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Last Update Date | 09/22/2007
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Provider Practice Location Address
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Address Line | 6191 S STATE ST STE 126
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City | MURRAY
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State | UT
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Zip | 84107-7264
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Country | US
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Telephone | 801-268-0408
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Fax |
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Provider Business Mailing Address
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Address Line | 9862 GRANITE SLOPE DR
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City | SANDY
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State | UT
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Zip | 84092-6004
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | BUSINESS OWNER
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Name | DR. JOSEPH P MARTIN
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Credential | O.D.
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Telephone | 801-674-8804
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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