Individual
WILLIAM HOWARD MOLLENKOPF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
140 N MARKET ST, CORTEZ, CO 81321-0820
(970) 565-2020
(970) 565-3632
Mailing address
PO BOX 820, CORTEZ, CO 81321
(970) 565-2020
(970) 565-3632
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
904
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08009045
—
CO
Enumeration date
12/26/2006
Last updated
02/24/2010
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