Organization
ARCHDALE EYECARE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THEODORE (TED) ARCHDALE OD (OWNER)
(719) 577-4400
Entity
Organization
Contact information
Practice address
1541 S 8TH ST, COLORADO SPRINGS, CO 80905-1923
(719) 577-4400
(719) 577-4954
Mailing address
1541 S 8TH ST, COLORADO SPRINGS, CO 80905-1923
(719) 577-4400
(719) 577-4954
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1466
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08014664
—
CO
01
—
1588660161
PERSONAL NPI
—
05
—
99752212
—
CO
Enumeration date
02/26/2007
Last updated
11/23/2010
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