NPI 1346764511 · live from the CMS NPI Registry
Richard Dallin Boardman
Optometrist in Logan, UT. National Provider Identifier 1346764511, active.
NPI record
| NPI | 1346764511 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Optometrist 152W00000X |
| Practice location | 810 S 100 W Ste A, Logan, UT 84321 |
| Practice phone | 435-787-7200 |
| Mailing address | 3485 N Cole Rd Unit 45479, Boise, ID 83711 |
| Enumerated | July 31, 2017 |
| Last updated | July 7, 2025 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | — |
| Optometrist primary | 152W00000X | ODP-100444 (ID) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.