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General NPI Number Information
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NPI Number | 1174952295
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Entity Type | Organization
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Legal Business Name | EYE-TECH VISION, LLC
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Dates
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Enumeration Date | 11/08/2013
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Last Update Date | 11/08/2013
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Provider Practice Location Address
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Address Line | 9325 DORCHESTER ST SUITE 124
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City | HIGHLANDS RANCH
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State | CO
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Zip | 80129-2520
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Country | US
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Telephone | 303-471-5263
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Fax | 303-471-5724
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Provider Business Mailing Address
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Address Line | 9325 DORCHESTER ST SUITE 124
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City | HIGHLANDS RANCH
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State | CO
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Zip | 80129-2520
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Country | US
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Telephone | 303-471-5263
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Fax | 303-471-5724
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Authorized Official
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Title or Position | OWNER/DOCTOR
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Name | DR. JOHN LAWSON
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Credential | O.D.
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Telephone | 303-471-5263
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number | 1361
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License Number State | CO
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