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General NPI Number Information
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NPI Number | 1184562795
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Entity Type | Organization
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Legal Business Name | EDGE OPTICS LLC
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Dates
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Enumeration Date | 03/24/2026
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Last Update Date | 03/24/2026
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Provider Practice Location Address
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Address Line | 602 N CLEVELAND AVE
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City | LOVELAND
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State | CO
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Zip | 80537-6009
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Country | US
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Telephone | 970-541-1443
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Fax | 970-913-0880
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Provider Business Mailing Address
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Address Line | 602 N CLEVELAND AVE
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City | LOVELAND
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State | CO
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Zip | 80537-6009
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Country | US
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Telephone | 970-541-1443
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Fax | 970-913-0880
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Authorized Official
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Title or Position | DIRECTOR/OPTOMETRIST
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Name | MASON T BRYANT
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Credential | OD
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Telephone | 970-682-2627
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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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