Provider Demographics
NPI:1396028510
Name:WEST POINT EYE CENTER LLC
Entity Type:Organization
Organization Name:WEST POINT EYE CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JUSTIN
Authorized Official - Middle Name:C
Authorized Official - Last Name:HOLT
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:801-825-9732
Mailing Address - Street 1:81 NO 2000 W
Mailing Address - Street 2:SUITE F-1
Mailing Address - City:WEST POINT
Mailing Address - State:UT
Mailing Address - Zip Code:84015
Mailing Address - Country:US
Mailing Address - Phone:801-825-9732
Mailing Address - Fax:801-825-4333
Practice Address - Street 1:81 N 2000 W
Practice Address - Street 2:SUITE F-1
Practice Address - City:WEST POINT
Practice Address - State:UT
Practice Address - Zip Code:84015
Practice Address - Country:US
Practice Address - Phone:801-825-9732
Practice Address - Fax:801-825-4333
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-23
Last Update Date:2017-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5345873-9934152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty