Provider Demographics
NPI:1568014934
Name:WINK LLC
Entity Type:Organization
Organization Name:WINK LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LIZ
Authorized Official - Middle Name:
Authorized Official - Last Name:ERLEY
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:303-443-4311
Mailing Address - Street 1:PO BOX 637
Mailing Address - Street 2:
Mailing Address - City:LYONS
Mailing Address - State:CO
Mailing Address - Zip Code:80540-0637
Mailing Address - Country:US
Mailing Address - Phone:303-995-2201
Mailing Address - Fax:
Practice Address - Street 1:3301 30TH ST
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80301-1401
Practice Address - Country:US
Practice Address - Phone:303-443-4311
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-15
Last Update Date:2019-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty