MEDICARE: DR. RORY J. CHRISTIAN O.D.

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
1	152W00000X	Optometrist	261044-9934	UT

General Provider Information

NPI Number	:	1326158551
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RORY J. CHRISTIAN O.D.

Provider Business Mailing Address
First Line	:	1811 W ROYAL HUNTE DR STE 1
Second Line	:
City	:	CEDAR CITY
State	:	UT
Zip	:	84720-8274
Country	:	US
Telephone Number	:	435-586-1131
Fax Number	:	435-865-1121

Provider Business Practice Location Address
First Line	:	1811 W ROYAL HUNTE DR STE 1
Second Line	:
City	:	CEDAR CITY
State	:	UT
Zip	:	84720-8274
Country	:	US
Telephone Number	:	435-586-1131
Fax Number	:	435-865-1121

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/30/2006
Last Update Date	:	11/09/2007

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