Confederated Tribes of the Goshute Indian Reservation

NPI #1023730413 in Slc, Utah

Provider Information

NPI Number: 1023730413
Entity Type: Organization
Organization Name: Confederated Tribes of the Goshute Indian Reservation
Primary Specialty: Optometrist
Enumeration Date: Sep 13, 2022
Last Updated: Sep 13, 2022

Practice Location

Address: 660 S 200 E STE 250
City: Slc
State: Utah
ZIP Code: 84111-3846
Phone: (801) 359-2256

Authorized Official

Name: CRYSTAL CONTRERAS
Title: BILLING MANAGER
Phone: (801) 359-2256

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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