Jennifer Havrilla LLC
Optometrist in Fort Collins, CO. Organization (NPI-2).
NPI number1114484656
StatusActive
Last updated in NPPESFeb 20, 2019
Details
- NPI
- 1114484656
- Entity type
- Organization (NPI-2)
- Legal business name
- Jennifer Havrilla LLC
- Organization subpart
- No
- Enumeration date
- Feb 20, 2019
- Last updated
- Feb 20, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 152W00000X | Optometrist | – | – | Yes |
Other names
- Colorado Vision Center (Doing Business As)
Practice location
2001 S Shields St Ste J1Fort Collins, CO 80526-1837
Phone 970-206-0100 · Fax 970-206-0300
Mailing address
2001 S Shields St Ste J1Fort Collins, CO 80526-1837
Phone 970-206-0100 · Fax 970-206-0300
Authorized official
Jennifer Havrilla
Owner
9702060100
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