Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 5350587-9934 | UT |
N | 152WC0802X | Optomitrist - Corneal and Contact Lenses | 5350587-9934 | UT |
N | 152WL0500X | Optomitrist - Low Vision Rehabilitation | 5350587-9934 | UT |
N | 152WP0200X | Pediatric Optomitrist | 5350587-9934 | UT |
NPI | 1306805510 |
---|---|
Provider Name | Dr. David Mcclean Graf |
First Address | Richfield, UT 84701-2131 |
Second Address | Richfield, UT 84701-2131 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/03/2006 |
Last Update Date | 10/02/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U97174 | (02) | UT |