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General NPI Number Information
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NPI Number | 1134778566
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Entity Type | Organization
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Legal Business Name | KERRY K JARVIS OD PLLC
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Dates
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Enumeration Date | 09/09/2019
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Last Update Date | 09/09/2019
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Provider Practice Location Address
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Address Line | 333 S ALLISON PKWY STE 120
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City | LAKEWOOD
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State | CO
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Zip | 80226-3115
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Country | US
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Telephone | 303-989-2020
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Fax | 844-875-0149
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Provider Business Mailing Address
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Address Line | 1575 S JACKSON ST
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City | DENVER
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State | CO
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Zip | 80210-3026
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Country | US
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Telephone | 970-590-7951
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. KERRY K JARVIS
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Credential | OD
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Telephone | 303-989-2020
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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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