Provider Demographics
NPI:1467086694
Name:ROCKY MOUNTAIN EYE TEAM INC
Entity Type:Organization
Organization Name:ROCKY MOUNTAIN EYE TEAM INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMISON
Authorized Official - Middle Name:GEORGE
Authorized Official - Last Name:LANGSTON
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:602-421-0150
Mailing Address - Street 1:650 N 500 W APT 303
Mailing Address - Street 2:
Mailing Address - City:PROVO
Mailing Address - State:UT
Mailing Address - Zip Code:84601-1585
Mailing Address - Country:US
Mailing Address - Phone:602-421-0150
Mailing Address - Fax:
Practice Address - Street 1:846 EXPRESSWAY LN
Practice Address - Street 2:
Practice Address - City:SPANISH FORK
Practice Address - State:UT
Practice Address - Zip Code:84660-1300
Practice Address - Country:US
Practice Address - Phone:602-421-0150
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-26
Last Update Date:2020-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty