Provider Demographics
NPI:1992840078
Name:ARICI, MARCO (OD)
Entity Type:Individual
Prefix:DR
First Name:MARCO
Middle Name:
Last Name:ARICI
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11100 AUTO MALL DR
Mailing Address - Street 2:CO OPTICAL
Mailing Address - City:SANDY
Mailing Address - State:UT
Mailing Address - Zip Code:84070-4171
Mailing Address - Country:US
Mailing Address - Phone:801-790-0012
Mailing Address - Fax:801-790-0013
Practice Address - Street 1:11100 AUTO MALL DR
Practice Address - Street 2:CO OPTICAL
Practice Address - City:SANDY
Practice Address - State:UT
Practice Address - Zip Code:84070-4171
Practice Address - Country:US
Practice Address - Phone:801-790-0012
Practice Address - Fax:801-790-0013
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT4796267152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist