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General NPI Number Information
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NPI Number | 1992693113
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Entity Type | Organization
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Legal Business Name | WYOMING VISION COLLECTIVE DESERT VIEW EYE CARE
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Dates
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Enumeration Date | 06/26/2025
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Last Update Date | 08/27/2025
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Provider Practice Location Address
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Address Line | 170 COMMERCE DR STE C
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City | GREEN RIVER
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State | WY
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Zip | 82935-6156
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Country | US
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Telephone | 307-875-3399
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Fax | 307-875-3778
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Provider Business Mailing Address
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Address Line | 170 COMMERCE DR STE C
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City | GREEN RIVER
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State | WY
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Zip | 82935-6156
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Country | US
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Telephone | 307-875-3399
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Fax | 307-875-3778
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Authorized Official
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Title or Position | MINORITY OWNER/OFFICE MANAGER
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Name | HALEIGH ROBERTSON
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Credential |
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Telephone | 307-371-3627
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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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