Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 5144747-9934 | UT |
NPI | 1013018084 |
---|---|
Provider Name | Richard I Yardley |
First Address | Draper, UT 84020-7133 |
Second Address | Richfield, UT 84701 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/09/2006 |
Last Update Date | 01/07/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U92223 | (02) | UT |