Organization
DALE G. LERVICK, O.D., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DALE GORDON LERVICK O.D. (OPTOMETRIST)
(303) 233-7575
Entity
Organization
Contact information
Practice address
7586 W JEWELL AVE, STE 104, LAKEWOOD, CO 80232-6890
(303) 233-7575
(303) 233-4740
Mailing address
7586 W JEWELL AVE, STE 104, LAKEWOOD, CO 80232-6890
(303) 233-7575
(303) 233-4740
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
9977799
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08007775
—
CO
Enumeration date
04/02/2008
Last updated
04/26/2012
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