| |
1341 N Main St, Logan, UT 84341-2221 | |
(435) 753-0700 | |
Not Available |
Full Name | |
---|---|
Type | Facility |
Speciality | Eyewear Supplier |
Location | 1341 N Main St, Logan, Utah |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1609828136 | NPI | - | NPPES |
35721 | Other | AVESIS | |
014091 | Other | VIP | |
410985054-148 | Medicaid | UT | |
CP2230-43 | Other | EYEMED | |
17924 | Other | MEDICARE | |
UT04878 | Other | UT | NORIDIAN SUBMITTER ID |
42567 | Other | DAVIS |
Mailing Address | Practice Location Address |
---|---|
1341 N Main St, Logan, UT 84341-2221 Ph: (435) 753-0700 | 1341 N Main St, Logan, UT 84341-2221 Ph: (435) 753-0700 |