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General NPI Number Information
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NPI Number | 1376974790
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Entity Type | Organization
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Legal Business Name | PROFESSIONAL VISION CARE, P.C.
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Dates
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Enumeration Date | 12/11/2013
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Last Update Date | 12/11/2013
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Provider Practice Location Address
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Address Line | 1580 BLAKE ST
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City | DENVER
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State | CO
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Zip | 80202-1322
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Country | US
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Telephone | 303-844-3937
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Fax | 303-844-3940
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Provider Business Mailing Address
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Address Line | 1580 BLAKE ST
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City | DENVER
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State | CO
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Zip | 80202-1322
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Country | US
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Telephone | 303-844-3937
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Fax | 303-844-3940
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Authorized Official
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Title or Position | PRESIDENT
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Name | MARIE SCHAEFER
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Credential | O.D.
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Telephone | 701-540-2307
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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 | 2978
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 2939
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License Number State | CO
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