Organization
LONGMONT VISION CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROGER TRUDELL O.D. (OWNER)
(303) 651-6700
Entity
Organization
Contact information
Practice address
412 MAIN ST, LONGMONT, CO 80501-5535
(303) 651-6700
(303) 776-9193
Mailing address
412 MAIN ST, LONGMONT, CO 80501-5535
(303) 651-6700
(303) 776-9193
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1188
CO
152W00000X
Optometrist
2365
CO
152W00000X
Optometrist
915
CO
Other
Enumeration date
08/20/2006
Last updated
01/17/2008
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