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Organization
CHILDREN'S OPTICAL OF NORTHERN COLORADO LLC
Active
Organization
CHILDREN'S OPTICAL OF NORTHERN COLORADO LLC
Active
Other names
Children's Optical
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL MITCHELL (MANAGER)
(970) 214-8175
Entity
Organization
Contact information
Practice address
2121 E HARMONY RD UNIT 350A, FORT COLLINS, CO 80528-3404
(970) 214-8175
(970) 788-7376
Mailing address
2121 E HARMONY RD UNIT 350A, FORT COLLINS, CO 80528-3404
(970) 214-8175
(970) 788-7376
Taxonomy
Speciality
Code
Description
License number
State
207WX0110X
Pediatric Ophthalmology and Strabismus Specialist Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1053572438
—
CO
05
—
1255091716
—
CO
Enumeration date
03/03/2023
Last updated
03/03/2023
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