| Organization Name: | UTAH VISION DEVELOPMENT CENTER, LLC |
| NPI Number: | 1104123801 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JARROD DAVIES (OPTOMETRIST) |
| Mailing Address: | 3672 W South Jordan Pkwy Ste 103 South Jordan |
| State: | UT US |
| Postal Code: | 840097171 |
| Phone Number: | 8018101060 |
| Fax Number: | |
| NPI Enumeration Date: | 02/16/2011 |
| NPI Last Update Date: | 05/20/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 152WS0006X |
| License Number: | 7383319-9934 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | UT |
| Taxonomy Type: | Eye and Vision Services Providers |
| Taxonomy Classification: | Optometrist |
| Taxonomy Specialization: | Sports Vision |
| Taxonomy Definition: | An optometrist who offers services designed to care for unique vision care needs of athletes, which may include one of more of the following services: corrective vision care unique to a specific sporting environment; protective eyewear for the prevention of sports-related injuries; vision enhancement |