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 |