Provider Demographics
NPI:1760648166
Name:DRS. KLEIM & RILEY, PC
Entity Type:Organization
Organization Name:DRS. KLEIM & RILEY, PC
Other - Org Name:DOVE VALLEY VISION CENTER, PC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:M
Authorized Official - Last Name:KLEIM
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:303-766-2020
Mailing Address - Street 1:15530 E BRONCOS PKWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80112-7111
Mailing Address - Country:US
Mailing Address - Phone:303-766-2020
Mailing Address - Fax:303-680-8337
Practice Address - Street 1:15530 E BRONCOS PKWY
Practice Address - Street 2:SUITE 200
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80112-7111
Practice Address - Country:US
Practice Address - Phone:303-766-2020
Practice Address - Fax:303-680-8337
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-05
Last Update Date:2008-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COCF0703Medicare PIN