| NPI | 1811596497 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLEY LYNNE HERNANDEZ Coa 719-484-8218 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 152W00000X Optometrist |
| 207W00000X Ophthalmology | |
| Enumeration Date | 2020-10-23 |
| Last Update Date | 2024-05-13 |