Provider Demographics
NPI:1558593145
Name:FAMILY FOCUSED EYECARE LLC
Entity Type:Organization
Organization Name:FAMILY FOCUSED EYECARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:HULET
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:801-885-6236
Mailing Address - Street 1:13446 FIREFLY LN
Mailing Address - Street 2:APT. #205
Mailing Address - City:RIVERTON
Mailing Address - State:UT
Mailing Address - Zip Code:84096-7226
Mailing Address - Country:US
Mailing Address - Phone:801-302-3080
Mailing Address - Fax:801-302-8008
Practice Address - Street 1:5528 W 13400 S
Practice Address - Street 2:
Practice Address - City:HERRIMAN
Practice Address - State:UT
Practice Address - Zip Code:84096-6919
Practice Address - Country:US
Practice Address - Phone:801-302-3080
Practice Address - Fax:801-302-8008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-14
Last Update Date:2009-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT73866879934152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty