| NPI | 1932470085 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMELA BURRELL CEO 970-433-5068 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CO OPT.0003341) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: AZ 1800) |
| Enumeration Date | 2012-01-21 |
| Last Update Date | 2019-03-14 |