Provider Demographics
NPI:1558963504
Name:PEAK VIEW OPTOMETRY SOUTH, PLLC
Entity Type:Organization
Organization Name:PEAK VIEW OPTOMETRY SOUTH, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHELSEY
Authorized Official - Middle Name:
Authorized Official - Last Name:NOLASCO
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:719-574-3300
Mailing Address - Street 1:PO BOX 63780
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80962-3780
Mailing Address - Country:US
Mailing Address - Phone:719-574-3300
Mailing Address - Fax:719-574-3322
Practice Address - Street 1:353 N ACADEMY BLVD
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80909-6605
Practice Address - Country:US
Practice Address - Phone:719-574-3300
Practice Address - Fax:719-574-3322
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-13
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty