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NPI Code Detail

MEDICARE: DR. JENNIFER ELEFTHERIOU OWEN OPTOMETRIST OD

MEDICARE: DR. JENNIFER ELEFTHERIOU OWEN OPTOMETRIST 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
1152W00000XOptometrist2505CO

General Provider Information

NPI Number : 1922070028
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JENNIFER ELEFTHERIOU OWEN OPTOMETRIST OD
Provider Business Mailing Address
First Line : 9806 ROCKINGHAM DR
Second Line :
City : PEYTON
State : CO
Zip : 80831-6440
Country : US
Telephone Number : 719-322-3557
Fax Number :
Provider Business Practice Location Address
First Line : 1130 LAKE PLAZA DR
Second Line : STE 230
City : COLORADO SPRINGS
State : CO
Zip : 80906-3594
Country : US
Telephone Number : 719-219-3819
Fax Number : 719-219-0411
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/02/2006
Last Update Date : 11/20/2009

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