Organization
EYE PROS OF LOGAN LLC
Active
Other names
Eye Pros
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LAVAR WENDELL KOFOED OD (OWNER)
(208) 447-9965
Entity
Organization
Contact information
Practice address
1475 N MAIN ST STE 103, LOGAN, UT 84341
(208) 501-8222
Mailing address
3485 N COLE RD UNIT 45479, BOISE, ID 83711-1095
(208) 297-7019
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Enumeration date
06/05/2018
Last updated
02/22/2021
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