Provider Demographics
NPI:1518266188
Name:ADLER, HEATHER MARIE (OD)
Entity Type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:MARIE
Last Name:ADLER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:
Other - Last Name:ADLER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 549
Mailing Address - Street 2:12470 YORK STREET
Mailing Address - City:EASTLAKE
Mailing Address - State:CO
Mailing Address - Zip Code:80614-0549
Mailing Address - Country:US
Mailing Address - Phone:303-842-7632
Mailing Address - Fax:
Practice Address - Street 1:10669 MELODY DR
Practice Address - Street 2:
Practice Address - City:NORTHGLENN
Practice Address - State:CO
Practice Address - Zip Code:80234-4113
Practice Address - Country:US
Practice Address - Phone:303-842-7632
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-22
Last Update Date:2021-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14077152W00000X
CO2823152W00000X, 152WC0802X, 152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management