Provider Demographics
NPI:1275770117
Name:FRONT RANGE VISION CARE, PLLC
Entity Type:Organization
Organization Name:FRONT RANGE VISION CARE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRANDY
Authorized Official - Middle Name:L
Authorized Official - Last Name:MORROW
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:970-377-2020
Mailing Address - Street 1:2321 BELLWETHER LN
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80521-1553
Mailing Address - Country:US
Mailing Address - Phone:970-377-2020
Mailing Address - Fax:970-377-3937
Practice Address - Street 1:204 MAPLE STREET, SUITE 103
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80524
Practice Address - Country:US
Practice Address - Phone:970-377-2020
Practice Address - Fax:970-377-3937
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-14
Last Update Date:2009-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2563152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
K21600Medicare PIN
V06882Medicare UPIN