Provider Demographics
NPI:1982146643
Name:ROCKWOOD OPTOMETRY, PC
Entity Type:Organization
Organization Name:ROCKWOOD OPTOMETRY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:PERRY
Authorized Official - Last Name:ROCKWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:801-694-7243
Mailing Address - Street 1:315 W WEBER HIGH DR
Mailing Address - Street 2:
Mailing Address - City:PLEASANT VIEW
Mailing Address - State:UT
Mailing Address - Zip Code:84414-1456
Mailing Address - Country:US
Mailing Address - Phone:801-694-7243
Mailing Address - Fax:888-843-0491
Practice Address - Street 1:348 E 2600 N
Practice Address - Street 2:
Practice Address - City:NORTH OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84414-2278
Practice Address - Country:US
Practice Address - Phone:801-701-7836
Practice Address - Fax:888-843-0491
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-12
Last Update Date:2016-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT59500478908152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty