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General NPI Number Information
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NPI Number | 1710534912
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Entity Type | Organization
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Legal Business Name | SIMONSON VISION CARE
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Dates
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Enumeration Date | 08/22/2019
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Last Update Date | 08/22/2019
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Provider Practice Location Address
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Address Line | 1265 SERGEANT JON STILES DR.
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City | HIGHLANDS RANCH
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State | CO
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Zip | 80129-8012
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Country | US
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Telephone | 720-344-6104
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Fax |
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Provider Business Mailing Address
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Address Line | 5031 E MINERAL CIR
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City | CENTENNIAL
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State | CO
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Zip | 80122-3840
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JAMES ALAN SIMONSON
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Credential | OD
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Telephone | 720-344-6104
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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