Provider Demographics
NPI:1659609279
Name:20-20 EYECARE OF UTAH LLC
Entity type:Organization
Organization Name:20-20 EYECARE OF UTAH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:ROPER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:801-966-2020
Mailing Address - Street 1:373 BRAMBLEBERRY LN
Mailing Address - Street 2:
Mailing Address - City:DRAPER
Mailing Address - State:UT
Mailing Address - Zip Code:84020-9412
Mailing Address - Country:US
Mailing Address - Phone:801-619-8067
Mailing Address - Fax:
Practice Address - Street 1:3544 W 6200 S
Practice Address - Street 2:UNIT #104
Practice Address - City:TAYLORSVILLE
Practice Address - State:UT
Practice Address - Zip Code:84118-3205
Practice Address - Country:US
Practice Address - Phone:801-966-2020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-19
Last Update Date:2009-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT51898809934152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty