Provider Demographics
NPI:1396869947
Name:STROMNESS VISION PC
Entity type:Organization
Organization Name:STROMNESS VISION PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF OPTOMETRY
Authorized Official - Prefix:DR
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:D
Authorized Official - Last Name:STROMNESS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:801-576-1145
Mailing Address - Street 1:9565 S 700 E
Mailing Address - Street 2:#101
Mailing Address - City:SANDY
Mailing Address - State:UT
Mailing Address - Zip Code:84070-3482
Mailing Address - Country:US
Mailing Address - Phone:801-576-1145
Mailing Address - Fax:801-576-8316
Practice Address - Street 1:9565 S 700 E
Practice Address - Street 2:#101
Practice Address - City:SANDY
Practice Address - State:UT
Practice Address - Zip Code:84070-3482
Practice Address - Country:US
Practice Address - Phone:801-576-1145
Practice Address - Fax:801-576-8316
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-19
Last Update Date:2009-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
U10196Medicare UPIN