Provider Demographics
NPI:1053828368
Name:BLUEJAY, LLC
Entity Type:Organization
Organization Name:BLUEJAY, LLC
Other - Org Name:PERFORMANCE VISION AND LEARNING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:
Authorized Official - Last Name:SPINOZZI
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:970-460-0836
Mailing Address - Street 1:400 MAIN ST STE D
Mailing Address - Street 2:
Mailing Address - City:WINDSOR
Mailing Address - State:CO
Mailing Address - Zip Code:80550-4796
Mailing Address - Country:US
Mailing Address - Phone:970-460-0836
Mailing Address - Fax:
Practice Address - Street 1:400 MAIN ST STE D
Practice Address - Street 2:
Practice Address - City:WINDSOR
Practice Address - State:CO
Practice Address - Zip Code:80550-4796
Practice Address - Country:US
Practice Address - Phone:970-460-0836
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-08
Last Update Date:2018-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty