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General NPI Number Information
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NPI Number | 1275967416
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Entity Type | Organization
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Legal Business Name | ALISON C. HOUSE, O.D., PC
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Dates
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Enumeration Date | 08/23/2013
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Last Update Date | 02/23/2015
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Provider Practice Location Address
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Address Line | 1821 FORTINO BLVD
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City | PUEBLO
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State | CO
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Zip | 81008-1892
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Country | US
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Telephone | 719-583-0344
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Fax | 719-583-2806
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Provider Business Mailing Address
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Address Line | 1821 FORTINO BLVD
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City | PUEBLO
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State | CO
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Zip | 81008-1892
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Country | US
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Telephone | 719-583-0344
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Fax | 719-583-2806
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Authorized Official
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Title or Position | OPTOMETRIST/OWNER
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Name | ALISON C HOUSE
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Credential | O.D.
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Telephone | 719-583-0344
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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 | 1360
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License Number State | CO
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