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General NPI Number Information
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NPI Number | 1588341762
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Entity Type | Organization
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Legal Business Name | RED ROCKS EYECARE LLC
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Dates
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Enumeration Date | 06/29/2023
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Last Update Date | 08/02/2023
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Provider Practice Location Address
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Address Line | 5885 BARNES RD
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City | COLORADO SPRINGS
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State | CO
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Zip | 80922-3512
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Country | US
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Telephone | 915-345-8952
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Fax | 719-631-0711
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Provider Business Mailing Address
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Address Line | 5885 BARNES RD
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City | COLORADO SPRINGS
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State | CO
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Zip | 80922-3512
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Country | US
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Telephone | 719-602-2006
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Fax |
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Authorized Official
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Title or Position | CONTROLLER
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Name | BRENT MEYER
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Credential |
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Telephone | 719-602-2006
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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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