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General NPI Number Information
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NPI Number | 1194133827
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Entity Type | Organization
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Legal Business Name | MONTGOMERY EYE CARE PC
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Dates
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Enumeration Date | 07/25/2014
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Last Update Date | 07/25/2014
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Provider Practice Location Address
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Address Line | 10465 MELODY DR STE 111
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City | NORTHGLENN
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State | CO
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Zip | 80234-4119
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Country | US
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Telephone | 303-252-9981
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Fax | 303-252-7306
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Provider Business Mailing Address
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Address Line | 10465 MELODY DR STE 111
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City | NORTHGLENN
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State | CO
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Zip | 80234-4119
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Country | US
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Telephone | 303-252-9981
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Fax | 303-252-7306
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | DR. SIEGLINDE FREED
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Credential | PHD
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Telephone | 303-252-9981
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QS0132X
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Taxonomy Name | Ophthalmologic Surgery Clinic/Center
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License Number | 160496
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License Number State | CO
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