Provider Demographics
NPI:1760867402
Name:SALLECCHIA, LINDSAY M (OD)
Entity Type:Individual
Prefix:DR
First Name:LINDSAY
Middle Name:M
Last Name:SALLECCHIA
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6071 E WOODMEN RD STE 205
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80923-2609
Mailing Address - Country:US
Mailing Address - Phone:719-380-6808
Mailing Address - Fax:
Practice Address - Street 1:6071 E WOODMEN RD STE 205
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80923-2609
Practice Address - Country:US
Practice Address - Phone:719-380-6808
Practice Address - Fax:719-380-5656
Is Sole Proprietor?:No
Enumeration Date:2015-07-23
Last Update Date:2022-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOPT.6405152W00000X
COOPT.0003152152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist