Organization
HAVRILLA VISION PROFESSIONAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER HAVRILLA O.D. (OWNER)
(970) 629-1325
Entity
Organization
Contact information
Practice address
551 S HOVER ST, LONGMONT, CO 80501-7920
(970) 629-1325
Mailing address
704 E 5TH ST, LOVELAND, CO 80537-5744
(970) 629-1325
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0002925
CO
Other
Enumeration date
09/20/2012
Last updated
09/20/2012
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