Provider Demographics
NPI:1033381496
Name:LEHI VISION CARE
Entity Type:Organization
Organization Name:LEHI VISION CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ROGER
Authorized Official - Middle Name:M
Authorized Official - Last Name:PICKERING
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:801-766-1696
Mailing Address - Street 1:127 E MAIN ST
Mailing Address - Street 2:STE F
Mailing Address - City:LEHI
Mailing Address - State:UT
Mailing Address - Zip Code:84043
Mailing Address - Country:US
Mailing Address - Phone:801-766-1696
Mailing Address - Fax:801-766-1822
Practice Address - Street 1:127 E MAIN ST
Practice Address - Street 2:STE F
Practice Address - City:LEHI
Practice Address - State:UT
Practice Address - Zip Code:84043-2288
Practice Address - Country:US
Practice Address - Phone:801-766-1696
Practice Address - Fax:801-766-1822
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-26
Last Update Date:2008-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty