Organization
PHILIP WREN, O.D., A PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PHILIP WREN O.D. (PRESIDENT)
(303) 979-1550
Entity
Organization
Contact information
Practice address
8501 W BOWLES AVE, STE 1B-204, LITTLETON, CO 80123-9502
(303) 979-1550
(303) 979-1850
Mailing address
620 11TH ST, UNIT 202, GOLDEN, CO 80401-0704
(303) 979-1550
(303) 979-1850
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
12089T
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
W18120
MEDICARE GROUP PROVIDER #
CA
Enumeration date
08/28/2007
Last updated
09/26/2014
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