Provider Demographics
NPI:1912671421
Name:PEAK EYECARE PLLC
Entity Type:Organization
Organization Name:PEAK EYECARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DAVIS
Authorized Official - Middle Name:
Authorized Official - Last Name:CAPACCIOLI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-403-5655
Mailing Address - Street 1:3710 MAIN AVE STE 203
Mailing Address - Street 2:
Mailing Address - City:DURANGO
Mailing Address - State:CO
Mailing Address - Zip Code:81301-4033
Mailing Address - Country:US
Mailing Address - Phone:970-403-5655
Mailing Address - Fax:970-403-5964
Practice Address - Street 1:3710 MAIN AVE STE 203
Practice Address - Street 2:
Practice Address - City:DURANGO
Practice Address - State:CO
Practice Address - Zip Code:81301-4033
Practice Address - Country:US
Practice Address - Phone:970-403-5655
Practice Address - Fax:970-403-5964
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-07
Last Update Date:2021-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty