Havrilla Vision Professional Llc

NPI 1043561863 - Optometrist - 152W00000X

NPI Details
NPI 1043561863
Enumeration Date 09/20/2012
Last Updated 09/20/2012
Entity Type Healthcare Provider
Active Over 4 years ago
Authorized Information
Name JENNIFER JENNIFER
Position OWNER
Phone (970) 629-1325
Fax
Practice Location
551 S HOVER ST
LONGMONT CO, 80501-7920, US
Phone (970) 629-1325
Fax
Business Location
704 E 5TH ST
LOVELAND CO, 80537-5744, US
Phone (970) 629-1325
Fax
Toxanomy
Taxonomy Code 152W00000X
License State Colorado
License Number 0002925
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According to our database, Havrilla Vision Professional Llc NPI is 1043561863, taxonomy code is 152W00000X and license number is 0002925, license state is located at Colorado. Havrilla Vision Professional Llc physically located at 551 S Hover St, Longmont CO, 80501-7920. NPI Number 1033115704 has the healthcare provider type.

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1043561863 NPI number is provided on an as is basis without warranty of any kind. 1043561863 is maintained by the National Plan & Provider Enumeration System. The contents of Havrilla Vision Professional Llc are for informational purposes only.