Provider Demographics
NPI:1740047851
Name:CONTACT LENS INSTITUTE OF COLORADO
Entity type:Organization
Organization Name:CONTACT LENS INSTITUTE OF COLORADO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:NATALIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SANTELLI
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:970-372-9220
Mailing Address - Street 1:5236 STRAUSS CABIN RD
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80528-9555
Mailing Address - Country:US
Mailing Address - Phone:970-239-3929
Mailing Address - Fax:
Practice Address - Street 1:5236 STRAUSS CABIN RD
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80528-9555
Practice Address - Country:US
Practice Address - Phone:970-370-9220
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-05
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact ManagementGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO1982991550OtherCIGNA