| NPI | 1982655767 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLEY LYNNE HERNANDEZ Coa 719-484-8218 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology |
| Additional Taxonomies | 152W00000X Optometrist |
| Enumeration Date | 2006-05-15 |
| Last Update Date | 2024-05-13 |