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General NPI Number Information
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NPI Number | 1790943850
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Entity Type | Organization
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Legal Business Name | BRYAN VISION ASSOCIATES INC
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Dates
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Enumeration Date | 05/27/2008
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Last Update Date | 02/02/2012
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Provider Practice Location Address
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Address Line | 2525 S WADSWORTH BLVD 101
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City | LAKEWOOD
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State | CO
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Zip | 80227-3273
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Country | US
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Telephone | 303-986-5983
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Fax | 303-986-5473
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Provider Business Mailing Address
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Address Line | 2525 S WADSWORTH BLVD 101
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City | LAKEWOOD
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State | CO
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Zip | 80227-3273
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Country | US
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Telephone | 303-986-5983
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Fax | 303-986-5473
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. STACEY KRISTIN SPAULDING
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Credential | OD
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Telephone | 303-986-5983
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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 | CO
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