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Individual

MARIA T BISE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
O.D.

Contact information

Practice address
1130 LAKE PLAZA DR, SUITE 230, COLORADO SPRINGS, CO 80906-3594
(719) 219-3819
Mailing address
777 BANNOCK ST, DENVER, CO 80204-4597
(303) 436-4949
(303) 602-4560

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
OPC4485
FL
152W00000X
Optometrist
Primary
OPT.0002959
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
OPC4485
LICENSE
FL
01
OPT 2959
LICENSE
CO
Enumeration date
08/18/2009
Last updated
02/11/2025
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