MEDICARE: VALLEY VISION PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	152WC0802X	Corneal and Contact Management Optometrist
2	152WL0500X	Low Vision Rehabilitation Optometrist
3	152W00000X	Optometrist

General Provider Information

NPI Number	:	1184195117
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VALLEY VISION PC

Provider Business Mailing Address
First Line	:	904 PITKIN AVE
Second Line	:
City	:	GLENWOOD SPRINGS
State	:	CO
Zip	:	81601-3354
Country	:	US
Telephone Number	:	303-905-1616
Fax Number	:

Provider Business Practice Location Address
First Line	:	904 PITKIN AVE
Second Line	:
City	:	GLENWOOD SPRINGS
State	:	CO
Zip	:	81601-3354
Country	:	US
Telephone Number	:	970-945-6011
Fax Number	:	970-945-5627

Authorized Official
Title or Position	:	OPTOMETRIST
Name	:	DR. JENNIFER RYAN ZWELLING
Credential	:	OD, FAAO
Telephone Number	:	303-905-1616

Provider Enumeration Date	:	12/17/2018
Last Update Date	:	02/12/2019

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Directions to “VALLEY VISION PC ” Practice Location

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