Individual
DR. PHILIP WREN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
6545 GUNPARK DR, STE 250, BOULDER, CO 80301-3347
(303) 530-1973
(720) 638-1223
Mailing address
6545 GUNPARK DR, STE 250, BOULDER, CO 80301-3347
(303) 530-1973
(720) 638-1223
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1938
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11798239
CAQH
—
05
—
69172587
—
CO
Enumeration date
11/15/2006
Last updated
03/27/2017
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