Organization
PARK WEST VISION, LLC
Active
Other names
Park West Vision, Park West Dental & Vision
Organization subpart
No
Provider details
NPI number
Authorized official
JOE LEE (PARTNER)
(719) 289-2113
Entity
Organization
Contact information
Practice address
3470 PARKER BLVD, PUEBLO, CO 81008
(719) 553-7149
(719) 266-6163
Mailing address
3470 PARKER BLVD STE B, PUEBLO, CO 81008-2280
(719) 289-2113
(719) 266-6163
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
OPT0002851
CO
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1093233348
ISSUED BY NPI GOVERNING BODY
CO
01
—
1629303284
ISSUED BY PACIFIC UNIVERSITY DURING OPTOMETRY SCHOOL
—
Enumeration date
09/07/2017
Last updated
07/17/2018
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