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NPI Code Detail

MEDICARE: KELLY T VU OD

MEDICARE: KELLY T VU OD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometrist2027CO

General Provider Information

NPI Number : 1548241318
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELLY T VU OD
Provider Business Mailing Address
First Line : 6062 S TELLURIDE CIR
Second Line :
City : AURORA
State : CO
Zip : 80016-3202
Country : US
Telephone Number : 303-796-8227
Fax Number :
Provider Business Practice Location Address
First Line : 7805 E 35TH AVE
Second Line :
City : DENVER
State : CO
Zip : 80238-2458
Country : US
Telephone Number : 720-941-8479
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/09/2005
Last Update Date : 02/12/2021

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