Provider Demographics
NPI:1740032176
Name:LITTLE VALLEY EYE CARE
Entity type:Organization
Organization Name:LITTLE VALLEY EYE CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:BLAKE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:435-200-1987
Mailing Address - Street 1:2557 S RIVER RD STE B3
Mailing Address - Street 2:
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84790-8916
Mailing Address - Country:US
Mailing Address - Phone:435-200-1987
Mailing Address - Fax:435-200-1185
Practice Address - Street 1:2557 S RIVER ROAD
Practice Address - Street 2:#B3
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790
Practice Address - Country:US
Practice Address - Phone:435-633-3256
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-01
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty