Healthcare Provider Details

I. General information

NPI: 1750613634
Provider Name (Legal Business Name): COMPREHENSIVE EYE CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/03/2010
Last Update Date: 02/03/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3900 E MEXICO AVE #100
DENVER CO
80210-3940
US

IV. Provider business mailing address

625 IVY ST
DENVER CO
80220-5341
US

V. Phone/Fax

Practice location:
  • Phone: 303-482-1300
  • Fax:
Mailing address:
  • Phone: 720-987-9561
  • Fax: 303-284-3570

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number1235
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License Number1235
License Number StateCO

VIII. Authorized Official

Name: DR. MARCIE S. MUNISHOR
Title or Position: SOLE MEMBER
Credential: O.D.
Phone: 720-987-9561