Marty, Michael

Marty, Michael is an individual health care provider with primary practice located at 6525 S State St C/O Optical, Murray UT 84107-7218. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Marty, Michael can be contacted via phone (801) 685-7989.

Contact Information

Primary practice address
6525 S State St C/O Optical Murray UT 84107-7218
Fax: (801) 685-9105
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 2774349934 Utah

Profile Details

NPI number 1497743942
LBN Legal business name Marty, Michael
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 10th, 2005
Last updated Apr 22nd, 2008 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1497743942 NPPES
Utah MEDICAID 999000797009
Utah Other 87017934007001

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