| NPI | 1720203862 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTINE DARLENE BEAL Operations Director 719-473-9595 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CO 28079) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CO 38699) |
| 207W00000X Ophthalmology (Licence: CO 42148) | |
| Enumeration Date | 2007-04-16 |
| Last Update Date | 2023-10-05 |