Organization
DR KEVIN ANDERSON & ASSOCIATES, PC.
Active
Parent organization
DR KEVIN ANDERSON & ASSOCIATES, PC.
Other names
Village Optical
Organization subpart
Yes
Provider details
NPI number
Legal business name
DR KEVIN ANDERSON & ASSOCIATES, PC.
Authorized official
MS. DEBI WELBORN (OFFICE MANAGER)
(970) 223-0592
Entity
Organization
Contact information
Practice address
4103 BOARDWALK DR, SUITE 100, FORT COLLINS, CO 80525-5931
(970) 223-0592
(970) 377-1082
Mailing address
4103 BOARDWALK DR, SUITE 100, FORT COLLINS, CO 80525-5931
(970) 223-0592
(970) 377-1082
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT 1342
CO
332B00000X
Durable Medical Equipment & Medical Supplies
CO1342
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04011250
—
CO
01
—
DD2107
RAILROAD MEDICARE
CO
Enumeration date
11/28/2007
Last updated
01/12/2011
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