| NPI | 1073742938 |
|---|---|
| Doing Business As | SOUTHGLENN EYECARE, PC |
| Entity Type | Organization |
| Authorized Contact | JON F PEDERSON Owner 303-798-5533 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Enumeration Date | 2009-07-13 |
| Last Update Date | 2020-09-15 |