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General NPI Number Information
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NPI Number | 1730299116
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Entity Type | Organization
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Legal Business Name | OPTOMETRIC ASSOCIATES PC
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 11/19/2024
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Provider Practice Location Address
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Address Line | 2080 N MAIN ST
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City | LONGMONT
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State | CO
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Zip | 80501-1916
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Country | US
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Telephone | 303-651-2020
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Fax | 303-776-2460
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Provider Business Mailing Address
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Address Line | 2080 N MAIN ST
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City | LONGMONT
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State | CO
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Zip | 80501-1916
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Country | US
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Telephone | 303-651-2020
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Fax | 303-776-2460
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Authorized Official
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Title or Position | OWNER/OPTOMETRIST
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Name | RACHEL A POTTER
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Credential | OD
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Telephone | 303-651-2020
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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 |
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License Number State |
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