Individual
RUSSELL POLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
7007 E 88TH AVE, L-50, HENDERSON, CO 80640-8214
(720) 940-6335
Mailing address
8759 W CORNELL AVE, 8, LAKEWOOD, CO 80227-4879
(720) 940-6335
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
—
—
Other
Enumeration date
10/13/2015
Last updated
10/13/2015
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