| NPI | 1801195961 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIE A LARSON Optometrist/Owner 970-263-4525 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: CO 2269) |
| Enumeration Date | 2011-03-15 |
| Last Update Date | 2011-03-15 |