Healthcare Provider Details

I. General information

NPI: 1487058491
Provider Name (Legal Business Name): ROCKY MOUNTAIN EYE CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/20/2014
Last Update Date: 08/18/2020
Certification Date: 08/18/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9362 GRAND CORDERA PKWY STE 110
COLORADO SPRINGS CO
80924-7007
US

IV. Provider business mailing address

9362 GRAND CORDERA PKWY STE 110
COLORADO SPRINGS CO
80924-7007
US

V. Phone/Fax

Practice location:
  • Phone: 719-888-4688
  • Fax:
Mailing address:
  • Phone: 719-888-4688
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License Number
License Number State

VIII. Authorized Official

Name: TED R LYMER
Title or Position: PRESIDENT
Credential: OD
Phone: 719-888-4688