Tom'S Sportique Eyewear
Durable Medical Equipment & Medical Supplies in Boulder, CO. Organization (NPI-2).
NPI number1760616148
StatusActive
Last updated in NPPESFeb 1, 2011
Details
- NPI
- 1760616148
- Entity type
- Organization (NPI-2)
- Legal business name
- Tom'S Sportique Eyewear
- Organization subpart
- No
- Enumeration date
- May 13, 2009
- Last updated
- Feb 1, 2011
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 332B00000X | Durable Medical Equipment & Medical Supplies | – | – | Yes |
Practice location
3121 28th StBoulder, CO 80301-1315
Phone 303-442-2010 · Fax 303-442-2010
Mailing address
3121 28th StBoulder, CO 80301-1315
Phone 303-442-2010 · Fax 303-442-2010
Authorized official
Thomis Buell
Owner/Optician
3034422010
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