Aeg Utah Professional INC

NPI #1154212777 in Logan, Utah

Provider Information

NPI Number: 1154212777
Entity Type: Organization
Organization Name: Aeg Utah Professional INC
Primary Specialty: Optometrist
Enumeration Date: Jul 11, 2025
Last Updated: Jul 11, 2025

Practice Location

Address: 1300 N 200 E STE 104
City: Logan
State: Utah
ZIP Code: 84341-2460
Phone: (435) 752-6453

Authorized Official

Name: MELISSA ALLISON
Title: SR. DIRECTOR MANAGED VISION CARE
Phone: (618) 604-5208

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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