Provider Demographics
NPI:1285927129
Name:WASATCH VIEW EYE CARE L L C
Entity type:Organization
Organization Name:WASATCH VIEW EYE CARE L L C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEFFERY
Authorized Official - Middle Name:LOVELL
Authorized Official - Last Name:MELLOR
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:801-858-2020
Mailing Address - Street 1:10412 S 2200 W
Mailing Address - Street 2:
Mailing Address - City:SOUTH JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84095-8333
Mailing Address - Country:US
Mailing Address - Phone:801-858-2020
Mailing Address - Fax:801-610-2138
Practice Address - Street 1:10412 S 2200 W
Practice Address - Street 2:
Practice Address - City:SOUTH JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84095-8333
Practice Address - Country:US
Practice Address - Phone:801-858-2020
Practice Address - Fax:801-610-2138
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-25
Last Update Date:2022-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT328094-9934152W00000X, 152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact ManagementGroup - Multi-Specialty