Organization
NORTHERN UTAH EYE CENTER
Active
Parent organization
NORTHERN UTAH EYE CENTER
Other names
The Optical Shoppe
Organization subpart
Yes
Provider details
NPI number
Legal business name
NORTHERN UTAH EYE CENTER
Authorized official
DR. CHRISTIAN D NILSON M.D. (OWNER)
(435) 752-2020
Entity
Organization
Contact information
Practice address
550 E 1400 N STE T, LOGAN, UT 84341-2407
(435) 752-2020
(435) 752-5475
Mailing address
550 E 1400 N STE T, LOGAN, UT 84341-2407
(435) 752-2020
(435) 752-5475
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
8127835-9934
UT
332H00000X
Eyewear Supplier
Primary
6962612-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1932321460
—
UT
Enumeration date
11/17/2010
Last updated
08/29/2017
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