Healthcare Provider Details

I. General information

NPI: 1609843390
Provider Name (Legal Business Name): MORRISON OPTOMETRIC ASSOCIATES PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/02/2006
Last Update Date: 05/31/2022
Certification Date: 05/31/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1275 ROSE AVE STE A
BURLINGTON CO
80807-1678
US

IV. Provider business mailing address

PO BOX 687
COLBY KS
67701-0687
US

V. Phone/Fax

Practice location:
  • Phone: 719-346-8415
  • Fax: 785-462-2307
Mailing address:
  • Phone: 785-462-8231
  • Fax: 785-462-2307

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: MARY J SHOAFF
Title or Position: PRACTICE MANAGER
Credential:
Phone: 785-462-8231