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NPI Code Detail

MEDICARE: DR. ROBIN ASHLEY SALLEY O.D.

MEDICARE: DR. ROBIN ASHLEY SALLEY O.D.
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
1152W00000XOptometrist1919CO

General Provider Information

NPI Number : 1831304971
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ROBIN ASHLEY SALLEY O.D.
Provider Business Mailing Address
First Line : 2015 N CASCADE AVE
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80907-6726
Country : US
Telephone Number : 719-475-2200
Fax Number : 719-578-5582
Provider Business Practice Location Address
First Line : 3201 E PLATTE AVE
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80909-6408
Country : US
Telephone Number : 719-578-0398
Fax Number : 719-578-5582
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/11/2007
Last Update Date : 07/08/2007

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