| NPI | 1316280258 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUTH BRAD Administrator 303-757-6747 |
| Organization Subpart ? | No |
| Primary Taxonomy | 156FX1800X Technician/Technologist Optician |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2013-03-28 |
| Last Update Date | 2017-03-24 |