| NPI | 1861533457 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANN M HULETT Administrator 719-545-1530 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology |
| Additional Taxonomies | 152W00000X Optometrist |
| 332H00000X Eyewear Supplier | |
| Enumeration Date | 2007-02-08 |
| Last Update Date | 2013-01-07 |