| NPI | 1396389680 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUNDIE CAPOBIANCO Billing Supervisor 719-473-9595 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist |
| Additional Taxonomies | 207W00000X Ophthalmology |
| Enumeration Date | 2019-10-30 |
| Last Update Date | 2022-03-31 |