Organization
HV PUEBLO SOUTH LLC
Active
Parent organization
HV PUEBLO SOUTH
Other names
Academy Kids Vision
Organization subpart
Yes
Provider details
NPI number
Legal business name
HV PUEBLO SOUTH
Authorized official
SHAUN URBANOZO (CREDENTIALING MANAGER)
(719) 323-2362
Entity
Organization
Contact information
Practice address
1725 S PUEBLO BLVD, PUEBLO, CO 81005-2103
(719) 281-2633
Mailing address
2221 E BIJOU ST STE 100, COLORADO SPRINGS, CO 80909-8009
(719) 576-1850
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
68820071
—
CO
Enumeration date
11/25/2020
Last updated
11/25/2020
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