Organization
NORTH COLORADO OPTICAL OF GREELEY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHON JAMES CUCKLER (OPTICIAN/MANAGER)
(970) 356-1047
Entity
Organization
Contact information
Practice address
1931 65TH AVE, SUITE C, GREELEY, CO 80634-7945
(970) 356-1047
Mailing address
1931 65TH AVE, SUITE C, GREELEY, CO 80634-7945
(970) 356-1047
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
12-43937-0000
CO
Other
Enumeration date
01/03/2008
Last updated
01/03/2008
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