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1043535008
PREMILLA BANWAIT
AURORA, CO
NPI
1043535008
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
152WP0200X Optometrist, Pediatrics
(Licence: CO 2805)
Enumeration Date
2010-04-02
Last Update Date
2012-08-16
Business Address
PREMILLA BANWAIT OD
13123 E 16TH AVE
AURORA, CO 80045-7106
Phone number: 720-777-1234
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Mailing Address
PREMILLA BANWAIT OD
PO BOX 110429
AURORA, CO 80042-0429
Phone number: 303-493-7000
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