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General NPI Number Information
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NPI Number | 1497997373
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Entity Type | Organization
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Legal Business Name | PEAK VISION OPTICAL CENTER, INC.
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Dates
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Enumeration Date | 03/24/2009
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Last Update Date | 01/21/2025
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Provider Practice Location Address
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Address Line | 3155 N UNION BLVD
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City | COLORADO SPRINGS
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State | CO
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Zip | 80907-8703
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Country | US
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Telephone | 719-630-3937
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Fax | 719-635-3578
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Provider Business Mailing Address
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Address Line | 3155 NORTH UNION BLVD
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City | COLORADO SPRINGS
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State | CO
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Zip | 80907
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Country | US
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Telephone | 719-630-3937
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Fax | 719-635-3578
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Authorized Official
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Title or Position | OWNER
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Name | MATTHEW CHANG
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Credential | M.D.
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Telephone | 719-630-3937
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number |
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License Number State |
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