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General NPI Number Information
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NPI Number | 1528559168
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Entity Type | Organization
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Legal Business Name | OPTOMETRIC GLASSES AND CONTACTS, PLLC
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Dates
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Enumeration Date | 05/18/2018
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Last Update Date | 05/18/2018
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Provider Practice Location Address
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Address Line | 880 S ABILENE ST
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City | AURORA
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State | CO
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Zip | 80012-3684
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Country | US
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Telephone | 303-695-6524
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Fax | 303-695-6526
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Provider Business Mailing Address
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Address Line | 8156 S WADSWORTH BLVD UNIT E306
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City | LITTLETON
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State | CO
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Zip | 80128-9114
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Country | US
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Telephone | 970-614-8654
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DAVID J OHSIEK
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Credential | OD
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Telephone | 970-614-8654
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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 | 2075
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License Number State | CO
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