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General NPI Number Information
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NPI Number | 1861617441
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Entity Type | Organization
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Legal Business Name | CHAPEL HILLS VISION DEVELOPMENT CENTER INC
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Dates
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Enumeration Date | 04/17/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 595 CHAPEL HILLS DRIVE STE 101
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City | COLORADO SPRINGS
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State | CO
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Zip | 80920
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Country | US
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Telephone | 719-599-5083
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Fax | 719-599-3291
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Provider Business Mailing Address
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Address Line | 595 CHAPEL HILLS DRIVE STE 101
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City | COLORADO SPRINGS
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State | CO
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Zip | 80920
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Country | US
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Telephone | 719-599-5083
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Fax | 719-599-3291
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Authorized Official
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Title or Position | OWNER OPTOMETRIST
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Name | DR. FRANK E PUCKETT
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Credential | DOCTOR OF OPTOMETRY
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Telephone | 719-599-5083
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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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