Evergreen Vision Clinic, PC
Eyewear Supplier (Equipment, not the service) in Evergreen, CO. Organization (NPI-2).
NPI number1487741542
StatusActive
Last updated in NPPESNov 2, 2007
Details
- NPI
- 1487741542
- Entity type
- Organization (NPI-2)
- Legal business name
- Evergreen Vision Clinic, PC
- Organization subpart
- No
- Enumeration date
- Oct 9, 2006
- Last updated
- Nov 2, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 332H00000X | Eyewear Supplier (Equipment, not the service) | 1747 | CO | Yes |
Practice location
30960 Stagecoach Blvd # W200Evergreen, CO 80439-7902
Phone 303-674-4143 · Fax 303-670-4081
Mailing address
30960 Stagecoach Blvd # W200Evergreen, CO 80439-7902
Authorized official
Daniel R. Hock
Optometrist
3036744143
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