NPI 1083817944

Blaine F. Bird, O.D., P.C.

Organisation Eyewear Supplier Provo, UT

Practice location

Address: 2255 N University Pkwy Suite #1, Provo, UT 84604-1588
Phone: (801) 374-2220
Fax: (801) 373-5439
Mailing address: 2255 N University Pkwy STE 1, Provo, UT 84604-7505

Authorised official

Name: Blaine F Bird
Title: President
Phone: (801) 374-2220

Registered specialties

Eyewear Supplier Primary

Suppliers Taxonomy 332H00000X Licence 1145549934 (UT)

Other Eyewear Supplier providers in Utah →

Registry record

NPI: 1083817944
Entity type: Organization
NPI issued: 7 Jun 2007
Record last updated: 29 Dec 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.