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General NPI Number Information
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NPI Number | 1558593145
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Entity Type | Organization
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Legal Business Name | FAMILY FOCUSED EYECARE LLC
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Dates
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Enumeration Date | 08/14/2009
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Last Update Date | 10/28/2009
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Provider Practice Location Address
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Address Line | 5528 W 13400 S
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City | HERRIMAN
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State | UT
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Zip | 84096-6919
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Country | US
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Telephone | 801-302-3080
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Fax | 801-302-8008
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Provider Business Mailing Address
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Address Line | 13446 FIREFLY LN APT. #205
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City | RIVERTON
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State | UT
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Zip | 84096-7226
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Country | US
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Telephone | 801-302-3080
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Fax | 801-302-8008
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Authorized Official
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Title or Position | OWNER
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Name | PAUL HULET
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Credential | O.D.
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Telephone | 801-885-6236
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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 | 73866879934
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License Number State | UT
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