Individual
JESSICA ANNE LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
883 N ACADEMY BLVD, COLORADO SPRINGS, CO 80909-8307
(719) 442-0071
(719) 473-5303
Mailing address
2221 E BIJOU ST STE 100, COLORADO SPRINGS, CO 80909-8009
(719) 576-1850
(719) 955-3470
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT.0003150
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
688000088
—
CO
01
—
OPT.0003150
CO OPTOMETRY LICENSE
CO
Enumeration date
12/14/2015
Last updated
06/12/2019
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