Organization · NPI-2

Academy Kids Vision Center LLC

Clinic/Center · Colorado Springs, CO

NPI number1639339930
StatusActive
Last updated in NPPESApr 29, 2021

Details

NPI
1639339930
Entity type
Organization (NPI-2)
Legal business name
Academy Kids Vision Center LLC
Organization subpart
No
Enumeration date
Jun 11, 2008
Certification date
Apr 29, 2021
Last updated
Apr 29, 2021

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261Q00000X Clinic/Center––Yes
152W00000X Optometrist––

Other names

  • Academy Kids Dental Vision And Orthodontics (Doing Business As)

Practice location

2436 S Academy Blvd
Colorado Springs, CO 80916-2408

Phone 719-391-2336 · Fax 719-391-1625

Mailing address

2221 E Bijou St.
Ste. 100
Colorado Springs, CO 80909

Phone 719-391-2336 · Fax 719-391-1625

Authorized official

Samantha B Leblanc
Credentialing Specialist
7193232372

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