Individual
STEPHEN RAY ROARK
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
O.D
Contact information
Practice address
3510 GALLEY RD, COLORADO SPRINGS, CO 80909-4353
(719) 597-4423
(719) 596-6440
Mailing address
11745 FORT WORTH RD, PEYTON, CO 80831-6721
(719) 597-4423
(719) 596-6440
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
CO1490
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08014904
—
CO
Enumeration date
06/16/2006
Last updated
07/09/2007
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