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General NPI Number Information
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NPI Number | 1063007235
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Entity Type | Organization
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Legal Business Name | COLORADO WEST OPHTHALMOLOGY ASSOC. PC
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Dates
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Enumeration Date | 03/09/2021
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Last Update Date | 03/09/2021
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Provider Practice Location Address
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Address Line | 1800 E PAVILION PL UNIT B
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City | MONTROSE
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State | CO
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Zip | 81401-5499
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Country | US
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Telephone | 970-249-1210
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Fax | 970-249-3057
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Provider Business Mailing Address
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Address Line | 1800 E PAVILION PL UNIT B
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City | MONTROSE
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State | CO
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Zip | 81401-5499
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Country | US
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Telephone | 970-249-1210
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Fax | 970-249-3057
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Authorized Official
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Title or Position | ADMINISTRATIVE ASSISTANT
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Name | LETICIA C WARE
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Credential |
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Telephone | 970-249-1210
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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