Healthcare Provider Details

I. General information

NPI: 1386813889
Provider Name (Legal Business Name): VISUALEYES EYECARE, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/28/2008
Last Update Date: 03/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

332 E ASPEN AVE STE 100
FRUITA CO
81521-2204
US

IV. Provider business mailing address

332 E ASPEN AVE STE 100
FRUITA CO
81521-2204
US

V. Phone/Fax

Practice location:
  • Phone: 970-858-2020
  • Fax: 970-858-6601
Mailing address:
  • Phone: 970-858-2020
  • Fax: 970-858-6601

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberCO2351
License Number StateCO

VIII. Authorized Official

Name: DR. GARY N QUARNBERG
Title or Position: PRESIDENT
Credential: O.D.
Phone: 970-858-2020