NPI 1114376746

Taylor Wade Blanco, OD

Practitioner Optometrist West Jordan, UT

Practice location

Address: 7555 S Center View CT STE 101, West Jordan, UT 84084-1970
Phone: (801) 566-5683

Registered specialties

Optometrist Primary

Eye and Vision Services Providers Taxonomy 152W00000X Licence 9822611-9934 (UT)

Other Optometrist providers in Utah →

Registry record

NPI: 1114376746
Entity type: Individual
Sex (as registered): Male
NPI issued: 4 Jun 2016
Record last updated: 4 Jan 2019

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.