Organization
PEAK VISION CANON CITY PROF, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRITT A. BUCKLEY M.D. (OWNER)
(719) 275-1523
Entity
Organization
Contact information
Practice address
2776 E MAIN ST, CANON CITY, CO 81212-4010
(719) 275-1523
(719) 275-6925
Mailing address
2776 E MAIN ST, CANON CITY, CO 81212-4010
(719) 275-1523
(719) 275-6925
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
89850092
—
CO
Enumeration date
08/31/2006
Last updated
06/12/2023
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