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General NPI Number Information
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NPI Number | 1346655016
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Entity Type | Individual
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Provider Name | KYLE ALLAN KASPER O.D.
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Gender | Male
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Dates
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Enumeration Date | 06/21/2014
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Last Update Date | 08/22/2016
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Provider Practice Location Address
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Address Line | 5050 N NEVADA AVE
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City | COLORADO SPRINGS
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State | CO
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Zip | 80918-8602
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Country | US
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Telephone | 901-736-4326
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Fax |
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Provider Business Mailing Address
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Address Line | 8167 SUMMERSET DR APT F
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City | COLORADO SPRINGS
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State | CO
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Zip | 80920-6129
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Country | US
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Telephone | 901-736-4326
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 0003053
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License Number State | CO
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