Provider Demographics
NPI:1134778566
Name:KERRY K JARVIS OD PLLC
Entity type:Organization
Organization Name:KERRY K JARVIS OD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KERRY
Authorized Official - Middle Name:K
Authorized Official - Last Name:JARVIS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:303-989-2020
Mailing Address - Street 1:1575 S JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80210-3026
Mailing Address - Country:US
Mailing Address - Phone:970-590-7951
Mailing Address - Fax:
Practice Address - Street 1:333 S ALLISON PKWY STE 120
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80226-3115
Practice Address - Country:US
Practice Address - Phone:303-989-2020
Practice Address - Fax:844-875-0149
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-09
Last Update Date:2019-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty