=====================================================
General NPI Number Information
=====================================================
NPI Number | 1366712549
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | LEHMANN VISION, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/05/2012
-----------------------------------------------------
Last Update Date | 07/10/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5885 BARNES RD
-----------------------------------------------------
City | COLORADO SPRINGS
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80922-3512
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 719-591-3013
-----------------------------------------------------
Fax | 719-591-2823
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3620 PONY TRACKS DR
-----------------------------------------------------
City | COLORADO SPRINGS
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80922-3061
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 719-591-3013
-----------------------------------------------------
Fax | 719-591-2823
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. ANICA LEHMANN
-----------------------------------------------------
Credential | O.D.
-----------------------------------------------------
Telephone | 719-963-8868
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 152W00000X
-----------------------------------------------------
Taxonomy Name | Optometrist
-----------------------------------------------------
License Number | 1922
-----------------------------------------------------
License Number State | CO
-----------------------------------------------------