Provider Demographics
NPI:1568064541
Name:PEAK VIEW OPTOMETRY PETERSON, PLLC
Entity Type:Organization
Organization Name:PEAK VIEW OPTOMETRY PETERSON, 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:719-574-5252
Mailing Address - Street 1:6110 MARTINEZ ST
Mailing Address - Street 2:
Mailing Address - City:FORT CARSON
Mailing Address - State:CO
Mailing Address - Zip Code:80913-2048
Mailing Address - Country:US
Mailing Address - Phone:719-574-5252
Mailing Address - Fax:
Practice Address - Street 1:1030 E STEWART AVE BLDG 2017
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80914-2900
Practice Address - Country:US
Practice Address - Phone:719-574-5252
Practice Address - Fax:719-631-7014
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-13
Last Update Date:2020-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty