| NPI | 1073567459 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANN M HULETT Administrator/Chief Executive Offic 719-545-1530 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology |
| Additional Taxonomies | 152W00000X Optometrist |
| 332H00000X Eyewear Supplier (Equipment, not the service) | |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2008-02-22 |