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Contact Information

JASON KOWALLIS, OD
165 W 200 N
ROOSEVELT, UT84066-2834
 Phone: 435-722-5890
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Optometrist

152W00000X 41 Optometry
 

Vision Therapy

152WV0400X 41 Optometry
Indicates primary specialty

NPI Profile & details for JASON KOWALLIS · (Male)

NPI # 1942561311
Status Active
Credentials OD (Doctor of Optometry)
Entity Individual
Enumeration date 06/01/2012
Last updated 02/02/2017 - About 9 years ago
Sole proprietor 1 No
Identifiers
  • UT License # 8288486
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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