Individual
EDMUND M HERB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
115 N TABOR ST, BUENA VISTA, CO 81211-1109
(719) 395-6356
Mailing address
PO BOX 1109, BUENA VISTA, CO 81211-1109
(719) 395-6356
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT1068
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08010688
—
CO
Enumeration date
09/25/2006
Last updated
10/11/2011
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