| NPI | 1194470047 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHERYL BARBER Provider Services Manager 970-221-2222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Additional Taxonomies | 207W00000X Ophthalmology |
| Enumeration Date | 2022-02-18 |
| Last Update Date | 2022-02-28 |