=====================================================
General NPI Number Information
=====================================================
NPI Number | 1144185778
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CHERRY GLEN SIGHT & STYLE, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/16/2025
-----------------------------------------------------
Last Update Date | 12/16/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 600 S HOLLY ST STE 106
-----------------------------------------------------
City | DENVER
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80246-1435
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 720-303-0898
-----------------------------------------------------
Fax | 720-303-0897
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 600 S HOLLY ST STE 106
-----------------------------------------------------
City | DENVER
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80246-1435
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 720-303-0898
-----------------------------------------------------
Fax | 720-303-0897
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CO-OWNER
-----------------------------------------------------
Name | DR. JAMES KEITH CUTLER
-----------------------------------------------------
Credential | OD
-----------------------------------------------------
Telephone | 815-302-9019
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 152WC0802X
-----------------------------------------------------
Taxonomy Name | Corneal and Contact Management Optometrist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------