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NPI Code Detail

MEDICARE: HEALTHY EYES ASSOCIATES LLC

MEDICARE: HEALTHY EYES ASSOCIATES LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometrist59229269934UT

General Provider Information

NPI Number : 1063619740
Entity Type Code : Organization
Provider Name (Legal Business Name) : HEALTHY EYES ASSOCIATES LLC
Provider Business Mailing Address
First Line : 8806 REDWOOD RD
Second Line : STE. 101
City : WEST JORDAN
State : UT
Zip : 84088-9337
Country : US
Telephone Number : 801-578-2020
Fax Number : 801-748-4892
Provider Business Practice Location Address
First Line : 8806 REDWOOD RD
Second Line : STE. 101
City : WEST JORDAN
State : UT
Zip : 84088-9337
Country : US
Telephone Number : 801-578-2020
Fax Number : 801-748-4892
Authorized Official
Title or Position : OPTOMETRIST
Name : DR. JORY T KIMBALL
Credential : O.D.
Telephone Number : 801-578-2020
Provider Enumeration Date : 06/27/2007
Last Update Date : 03/07/2013

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Directions to “HEALTHY EYES ASSOCIATES LLC ” Practice Location

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