| NPI | 1801206735 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONNA MOORE Owner 720-941-8429 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: CO 302R00000X) |
| Additional Taxonomies | 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: CO 332H00000) |
| Enumeration Date | 2014-04-30 |
| Last Update Date | 2014-04-30 |