| NPI | 1396389680 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTINE DARLENE BEAL Operations Director 719-473-9595 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology |
| Additional Taxonomies | 207WX0107X Ophthalmology, Retina Specialist |
| Enumeration Date | 2019-10-30 |
| Last Update Date | 2025-04-16 |