Healthcare Provider Details

I. General information

NPI: 1376476978
Provider Name (Legal Business Name): SKYLAR RILEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2026
Last Update Date: 06/28/2026
Certification Date: 06/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1725 E PROSPECT RD
FORT COLLINS CO
80525-1307
US

IV. Provider business mailing address

2809 E HARMONY RD STE 130
FORT COLLINS CO
80528-3110
US

V. Phone/Fax

Practice location:
  • Phone: 970-221-2222
  • Fax:
Mailing address:
  • Phone: 970-325-6278
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOPT.0004225
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: