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General NPI Number Information
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NPI Number | 1427718311
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Entity Type | Organization
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Legal Business Name | CV EYECARE, LLC
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Dates
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Enumeration Date | 12/20/2021
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Last Update Date | 12/20/2021
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Provider Practice Location Address
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Address Line | 9670 PROMINENT PT
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City | COLORADO SPRINGS
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State | CO
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Zip | 80924-5000
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Country | US
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Telephone | 719-495-0856
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Fax |
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Provider Business Mailing Address
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Address Line | 6429 FARTHING DRIVE, COLORADO SPRINGS CO 80906-7506
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City | COLORADO SPRINGS
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State | CO
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Zip | 80906
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Country | US
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Telephone | 803-457-1002
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Fax |
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | CAM-VAN LECARRELL
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Credential | OD
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Telephone | 803-457-1002
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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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