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General NPI Number Information
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NPI Number | 1588706188
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Entity Type | Organization
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Legal Business Name | FAMILY VISION CENTER OF STERLING PC
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Dates
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Enumeration Date | 02/12/2007
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Last Update Date | 12/31/2013
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Provider Practice Location Address
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Address Line | 419 W MAIN STREET
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City | STERLING
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State | CO
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Zip | 80751-0209
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Country | US
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Telephone | 970-522-2020
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Fax | 970-526-2020
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Provider Business Mailing Address
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Address Line | PO BOX 209
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City | STERLING
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State | CO
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Zip | 80751-0209
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Country | US
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Telephone | 970-522-2020
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Fax | 970-526-2020
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Authorized Official
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Title or Position | PRESIDENT OPTOMETRIST
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Name | TODD L WOLFLEY
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Credential |
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Telephone | 920-522-2020
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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 | MW0357233
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License Number State |
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