NPI 1306829569

Jeffrey L Broadhead, OD

Practitioner Optometrist South Jordan, UT

Practice location

Address: 3556 W 9800 S Suite 104, South Jordan, UT 84095-3211
Phone: (801) 253-6590
Fax: (801) 253-6591

Registered specialties

Optometrist Primary

Eye and Vision Services Providers Taxonomy 152W00000X Licence 4826018-9934 (UT)

Other Optometrist providers in Utah →

Registry record

NPI: 1306829569
Entity type: Individual
Sex (as registered): Male
NPI issued: 22 Nov 2005
Record last updated: 23 Jun 2015

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.