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General NPI Number Information
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NPI Number | 1710700810
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Entity Type | Organization
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Legal Business Name | EYE CARE ASSOCIATES OF CO, LLC
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Dates
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Enumeration Date | 11/06/2024
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Last Update Date | 11/06/2024
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Provider Practice Location Address
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Address Line | 15320 E ALAMEDA PKWY
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City | AURORA
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State | CO
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Zip | 80017-2066
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Country | US
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Telephone | 303-745-9400
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Fax |
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Provider Business Mailing Address
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Address Line | 230 KINGS HWY E STE 333
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City | HADDONFIELD
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State | NJ
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Zip | 08033-1907
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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 | CREDENTIALING MANAGER
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Name | MARQUETTA SHONTA LATIMORE
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Credential |
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Telephone | 515-771-3757
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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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