Healthcare Provider Details

I. General information

NPI: 1992954127
Provider Name (Legal Business Name): SPECS APPEAL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2008
Last Update Date: 12/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6905 S BROADWAY SUITE 51
LITTLETON CO
80122-8013
US

IV. Provider business mailing address

6905 S BROADWAY SUITE 51
LITTLETON CO
80122-8013
US

V. Phone/Fax

Practice location:
  • Phone: 303-798-7520
  • Fax: 303-798-1503
Mailing address:
  • Phone: 303-798-7520
  • Fax: 303-798-1503

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License Number936
License Number StateCO

VIII. Authorized Official

Name: DR. MARK S STRUM
Title or Position: PRESIDENT
Credential: O.D.
Phone: 303-798-7520