Provider Demographics
NPI:1942792809
Name:20-20 EYEVENUE
Entity Type:Organization
Organization Name:20-20 EYEVENUE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARCELLA
Authorized Official - Middle Name:MARINA
Authorized Official - Last Name:NEVERMANN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-405-2020
Mailing Address - Street 1:14676 DELAWARE ST UNIT 400
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80023-9184
Mailing Address - Country:US
Mailing Address - Phone:720-405-2020
Mailing Address - Fax:720-634-0728
Practice Address - Street 1:14676 DELAWARE ST UNIT 400
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80023-9184
Practice Address - Country:US
Practice Address - Phone:720-405-2020
Practice Address - Fax:720-634-0728
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-05
Last Update Date:2018-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty