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General NPI Number Information
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NPI Number | 1578449856
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Entity Type | Organization
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Legal Business Name | BLUE SKY OPTICAL GROUP
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Dates
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Enumeration Date | 08/13/2025
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Last Update Date | 08/13/2025
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Provider Practice Location Address
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Address Line | 7301 S SANTA FE DR UNIT 245
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City | LITTLETON
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State | CO
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Zip | 80120-3071
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Country | US
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Telephone | 303-706-9900
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Fax |
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Provider Business Mailing Address
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Address Line | 100 FILLMORE ST
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City | DENVER
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State | CO
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Zip | 80206-4916
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Country | US
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Telephone | 303-322-7507
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Fax |
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Authorized Official
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Title or Position | OPTOMETRIST / PRIMARY
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Name | DR. LAURIE F MICHOLSON
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Credential | OD
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Telephone | 303-706-9900
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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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