| Organization Name: | MT OGDEN EYE CENTER LLC |
| NPI Number: | 1740431428 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SARAH HOWELL (CREDENTIALING MANAGER) |
| Mailing Address: | 1551 Renaissance Towne Dr Suite 340 Bountiful |
| State: | UT US |
| Postal Code: | 840107667 |
| Phone Number: | 8014099900 |
| Fax Number: | 8014099901 |
| NPI Enumeration Date: | 10/01/2008 |
| NPI Last Update Date: | 04/10/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332H00000X |
| License Number: | 2012-42863 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | UT |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Eyewear Supplier (Equipment, not the service) |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. |