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General NPI Number Information
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NPI Number | 1659157030
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Entity Type | Organization
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Legal Business Name | HTI3
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Dates
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Enumeration Date | 09/01/2023
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Last Update Date | 09/01/2023
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Provider Practice Location Address
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Address Line | 2120 VILLAGE VISTA DR UNIT 130
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City | ERIE
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State | CO
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Zip | 80516-7073
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Country | US
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Telephone | 970-581-4586
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Fax |
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Provider Business Mailing Address
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Address Line | 180 KEN PRATT BLVD STE 200
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City | LONGMONT
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State | CO
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Zip | 80501-8974
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Country | US
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Telephone | 970-581-4586
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Fax |
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Authorized Official
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Title or Position | MBR
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Name | LORI EDWARDS
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Credential |
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Telephone | 970-581-4586
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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 |
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License Number State |
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