Provider Demographics
NPI:1760721724
Name:COLORADO VISION CENTER P C
Entity Type:Organization
Organization Name:COLORADO VISION CENTER P C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:
Authorized Official - Last Name:ASMUSSEN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:970-542-2291
Mailing Address - Street 1:1718 68TH AVE
Mailing Address - Street 2:
Mailing Address - City:GREELEY
Mailing Address - State:CO
Mailing Address - Zip Code:80634-8654
Mailing Address - Country:US
Mailing Address - Phone:970-542-2291
Mailing Address - Fax:970-542-2294
Practice Address - Street 1:1300 BARLOW RD
Practice Address - Street 2:
Practice Address - City:FORT MORGAN
Practice Address - State:CO
Practice Address - Zip Code:80701-4363
Practice Address - Country:US
Practice Address - Phone:970-542-2291
Practice Address - Fax:970-542-2294
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-11
Last Update Date:2013-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COOPT 1389152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty