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General NPI Number Information
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NPI Number | 1386234219
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Entity Type | Organization
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Legal Business Name | DENVER EYE CARE OD PLLC
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Dates
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Enumeration Date | 01/25/2021
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Last Update Date | 02/15/2021
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Provider Practice Location Address
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Address Line | 539 BRENTWOOD RD
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City | DENVER
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State | NC
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Zip | 28037
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Country | US
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Telephone | 704-812-7778
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Fax | 704-812-7779
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Provider Business Mailing Address
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Address Line | 539 BRENTWOOD RD
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City | DENVER
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State | NC
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Zip | 28037-0269
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Country | US
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Telephone | 704-812-7778
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Fax | 704-812-7779
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Authorized Official
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Title or Position | MEMBER
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Name | DR. KRISTIN SARAH O'BRIEN
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Credential | OD
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Telephone | 303-859-1413
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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 |
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License Number State |
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