Blaine F. Bird, O.d., P.c.

NPI #1083817944 in Provo, Utah

Provider Information

NPI Number: 1083817944
Entity Type: Organization
Organization Name: Blaine F. Bird, O.d., P.c.
Primary Specialty: Eyewear Supplier
Enumeration Date: Jun 7, 2007
Last Updated: Dec 29, 2008

Practice Location

Address: 2255 N UNIVERSITY PKWY
Address 2: SUITE #1
City: Provo
State: Utah
ZIP Code: 84604-1588
Phone: (801) 374-2220

Authorized Official

Name: DR. BLAINE F BIRD, O.D.
Title: PRESIDENT
Phone: (801) 374-2220

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Eyewear Supplier	332H00000X	Primary

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