NPI 1396798161
Shopko Stores Operating Co. LLC
Practice location
- Address
- 125 S State St, Orem, UT 84058-5419
- Phone
- (801) 225-4700
Authorised official
- Name
- Michael J Bettiga
- Title
- Sr. Vice President Health Services
- Phone
- (920) 429-4297
Registered specialties (3)
Eyewear Supplier
Primary
Optometrist
Registry record
- NPI
- 1396798161
- Entity type
- Organization
- NPI issued
- 19 May 2006
- Record last updated
- 10 Jul 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.