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General NPI Number Information
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NPI Number | 1568064541
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Entity Type | Organization
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Legal Business Name | PEAK VIEW OPTOMETRY PETERSON, PLLC
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Dates
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Enumeration Date | 11/13/2020
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Last Update Date | 11/13/2020
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Provider Practice Location Address
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Address Line | 1030 E STEWART AVE BLDG 2017
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City | COLORADO SPRINGS
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State | CO
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Zip | 80914-2900
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Country | US
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Telephone | 719-574-5252
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Fax | 719-631-7014
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Provider Business Mailing Address
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Address Line | 6110 MARTINEZ ST
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City | FORT CARSON
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State | CO
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Zip | 80913-2048
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Country | US
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Telephone | 719-574-5252
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. CHELSEY NOLASCO
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Credential | OD
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Telephone | 719-574-5252
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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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