Provider Demographics
NPI:1083889513
Name:HARLIN OPTOMETRY, PLLC
Entity Type:Organization
Organization Name:HARLIN OPTOMETRY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DUSTIN
Authorized Official - Middle Name:DERIC
Authorized Official - Last Name:HARLIN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:801-623-3723
Mailing Address - Street 1:4410 S 3080 E
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84124-3714
Mailing Address - Country:US
Mailing Address - Phone:801-556-7194
Mailing Address - Fax:
Practice Address - Street 1:350 HOPE AVE
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84115-5116
Practice Address - Country:US
Practice Address - Phone:801-484-8662
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-25
Last Update Date:2008-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT59480409934152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty