Boster Vision, LLC

Organization Active NPI Optometrist · Riverdale, UT

NPI 1801316138 · NPPES record last updated Jun 27, 2017

Key facts

NPI
1801316138
Entity type
Organization (NPI type 2)
Primary specialty
Optometrist 152W00000X
License
9051999-9934 (UT)
Legal business name
BOSTER VISION, LLC
Practice address
4848 S 900 W
Riverdale, UT 84405-3726
Phone
(801) 404-2825
NPI assigned
Jun 27, 2017
Organization subpart
No

Authorized official

Name
Jonathan Boster, O.D.
Title
Manager
Phone
(801) 404-2825

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist
Group: 193400000X SINGLE SPECIALTY GROUP
152W00000X 9051999-9934 UT Yes

Addresses

Primary practice location

4848 S 900 W
Riverdale, UT 84405-3726

Mailing address

2133 W 900 N
Farr West, UT 84404-9586
Phone (801) 404-2825

Other providers in Riverdale, UT

All providers in Riverdale, UT · Optometrist in Utah

Sources for this page

Verify at the official NPI Registry.